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2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,400 | 12,588,573 | Effectiveness of a multifaceted intervention on falls in nursing home residents. | OBJECTIVES To evaluate the effectiveness of a multifaceted , nonpharmaceutical intervention on incidence of falls and fallers . DESIGN Prospect i ve , cluster-r and omized , controlled 12-month trial . SETTING Six community nursing homes in Germany . PARTICIPANTS Long-stay residents ( n = 981 ) aged 60 and older ; mean age 85 ; 79 % female . INTERVENTIONS Staff and resident education on fall prevention , advice on environmental adaptations , progressive balance and resistance training , and hip protectors . MEASUREMENTS Falls , fallers , and fractures . RESULTS The incidence density rate of falls per 1,000 resident years ( RY ) was 2,558 for the control group ( CG ) and 1,399 for the intervention group ( IG ) ( relative risk ( RR ) = 0.55 , 95 % confidence interval ( CI ) = 0.41 - 0.73 ) . Two hundred forty-seven ( 52.3 % ) fallers were detected in the CG and 188 ( 36.9 % ) in the IG ( RR = 0.75 , 95 % CI = 0.57 - 0.98 ) . The incidence density rate of frequent fallers ( > 2/year ) was 115 ( 24.4 % ) for the CG and 66 ( 13.0 % ) for the IG ( RR = 0.56 , 95 % CI = 0.35 - 0.89 ) . The incidence density rate of hip fractures per 1,000 RY was 39 for the CG and 43 for the IG ( RR = 1.11 , 95 % CI = 0.49 - 2.51 ) . Other fractures were diagnosed with an incidence density rate of 52 per 1,000 RY for CG and 41 per 1,000 RY for IG ( RR = 0.78 , 95 % CI = 0.57 - 1.07 ) . CONCLUSION The incidence density rate of falls and fallers differed considerably between the control and intervention groups . The study was underpowered to demonstrate a significant difference of hip or nonhip fractures . Because of a low fracture rate in both groups , the investigation of fracture rates would have required a larger sample size to detect an effect of the intervention | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,401 | 16,813,773 | Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. | OBJECTIVES To determine the effects of moderate intensity group-exercise programs on falls , functional performance , and disability in older adults ; and to investigate the influence of frailty on these effects . DESIGN A 20-week , multicenter r and omized controlled trial , with 52-week follow-up . SETTING Fifteen homes for the elderly . PARTICIPANTS Two hundred seventy-eight men and women ( mean age + /- st and ard deviation , 85+/-6y ) . INTERVENTIONS Two exercise programs were r and omly distributed across 15 homes . The first program , functional walking ( FW ) , consisted of exercises related to daily mobility activities . In the second program , in balance ( IB ) , exercises were inspired by the principles of Tai Chi . Within each home participants were r and omly assigned to an intervention or a control group . Participants in the control groups were asked not to change their usual pattern of activities . The intervention groups followed a 20-week exercise program with 1 meeting a week during the first 4 weeks and 2 meetings a week during the remaining weeks . MAIN OUTCOME MEASURES Falls , Performance Oriented Mobility Assessment ( POMA ) , physical performance score , and the Groningen Activity Restriction Scale ( GARS ) ( measuring self-reported disability ) . RESULTS Fall incidence rate was higher in the FW group ( 3.3 falls/y ) compared with the IB ( 2.4 falls/y ) and control ( 2.5 falls/y ) groups , but this difference was not statistically significant . The risk of becoming a faller in the exercise groups increased significantly in the subgroup of participants who were classified as being frail ( hazard ratio [ HR ] = 2.95 ; 95 % confidence interval [ CI ] , 1.64 - 5.32 ) . For participants who were classified as being pre-frail , the risk of becoming a faller decreased ; this effect became significant after 11 weeks of training ( HR = .39 ; 95 % CI , .18-.88 ) . Participants in both exercise groups showed a small , but significant improvement in their POMA and physical performance scores . In the FW group , this held true for the GARS score as well . Post hoc analyses revealed that only the pre-frail participants improved their POMA and physical performance scores . CONCLUSIONS Fall-preventive moderate intensity group-exercise programs have positive effects on falling and physical performance in pre-frail , but not in frail elderly | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,402 | 1,562,427 | Effects of resistance and functional-skills training on habitual activity and constipation among older adults living in long-term care facilities: a randomized controlled trial | Background Large-scale RCTs comparing different types of exercise training in institutionalised older people are scarce , especially regarding effects on habitual physical activity and constipation . This study investigated the effects of different training protocol s on habitual physical activity and constipation of older adults living in long-term care facilities . Methods A r and omized controlled trial with 157 participants , aged 64 to 94 years , who were r and omly assigned to 1 ) resistance training ; 2 ) all-round functional-skills training ; 3 ) both ; or 4 ) an ' educational ' control condition . Habitual physical activity was assessed with a physical activity question naire and accelerometers . Constipation was assessed by a question naire . Measurements were performed at baseline and after six months of training . Results At baseline the median time spent sitting was 8.2 hr/d , the median time spent on activity of at least moderate intensity was 32 min/d . At baseline , about 22 % of the subjects were diagnosed with constipation and 23 % were taking laxatives . There were no between-group differences for changes in habitual physical activity or constipation over 6-months . ConclusionS ix months of moderate intensity exercise training neither enhances habitual physical activity nor affects complaints of constipation among older people living in long-term care facilities | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,403 | 12,952,151 | Specific effects of balance and gait exercises on physical function among the frail elderly | Objective : To evaluate the specific effects of balance and gait exercises among frail elderly individuals . Design : A r and omized three-group parallel controlled study . Setting : Geriatric health services facility in Japan . Subjects : Thirty-four frail elderly subjects attending the care facility were r and omized into a control group , an exercise group with emphasis on balance or an exercise group with emphasis on gait re-education . Interventions : The two exercise groups received balance or gait exercise for 40 minutes , 2–3 times weekly , for 12 weeks . Main outcome measures : One Leg St and ing Test , Functional Reach Test , Manual Perturbation Test , Functional Balance Scale , Performance-Oriented Mobility Assessment , Timed ‘ Up and Go ’ Test and Stair Climbing/Descending Test . These assessment s were performed before and after 12-week intervention . Results : Comparison of the performance before and after intervention demonstrated significant improvement in One Leg St and ing Test , Functional Reach Test and Functional Balance Scale in the balance exercise group , and Functional Balance Scale , Timed ‘ Up and Go ’ Test and Stair Descending Test showed improvement in the gait exercise group . All test items showed no significant differences in the control groups . Among the three groups , the balance exercise group showed more significant improvement in Functional Balance Scale , and the gait exercise group showed more significant improvement in Performance-Oriented Mobility Assessment than the control group . The balance exercise group showed greater improvement in performance in Functional Reach Test than the gait exercise group . Conclusions : Balance exercises led to improvements in static balance function , and gait exercises result ed in improvements to dynamic balance and gait functions in the very frail elderly | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,404 | 8,301,766 | A randomized trial of physical rehabilitation for very frail nursing home residents. | BACKGROUND Past studies suggest multidisciplinary interventions that include physical therapy ( PT ) can improve function of nursing home residents . This trial specifically evaluates effects of PT for frail long-stay nursing home residents . DESIGN R and omized , controlled trial . SETTING One academic nursing home and eight community nursing homes . PATIENTS A total of 194 elderly nursing home residents dependent in at least two activities of daily living residing in the nursing home for at least 3 months . INTERVENTIONS Patients were r and omized to individually tailored one-on-one PT sessions or friendly visits ( FVs ) three times a week for 4 months . Physical therapy included range-of-motion , strength , balance , transfer , and mobility exercises . MAIN OUTCOME MEASURES Performance-based physical function assessed by the Physical Disability Index ; self-perceived health status assessed with the Sickness Impact Profile ; observer-reported activities of daily living ; and falls . RESULTS Eighty-nine percent and 92 % of PT and FV sessions , respectively , were attended ; 5 % and 9 % of subjects dropped out in the PT group and FV group , respectively . Compared with the FV group , the PT group experienced no significant improvements in overall Physical Disability Index , Sickness Impact Profile , or activities of daily living scores . A 15.5 % improvement in the mobility subscale of the Physical Disability Index was seen ( 95 % confidence interval [ CI ] , 6.4 % to 24.7 % ) ; no benefits in range-of-motion , strength , or balance subscales were found . Compared with the FV group , the PT group used assistive devices for bed mobility tasks less often ( P = .06 ) and were less likely to use assistive devices and wheelchairs for locomotion ( P < .005 ) . There were 79 falls in the PT group vs 60 falls in the FV group ( P = .11 ) . Charge for the 4-month PT program was $ 1220 per subject ( 95 % CI , $ 412 to $ 1832 ) . CONCLUSION This st and ardized physical therapy program provided modest mobility benefits for very frail long-stay nursing home residents with physical disability due to multiple comorbid conditions | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,405 | 15,123,761 | Physiological and functional responses to low-moderate versus high-intensity progressive resistance training in frail elders. | BACKGROUND The purpose of this efficacy study was to measure the dose-response effect of a free weight-based resistance training program by comparing the effects of two training intensities ( low-moderate and high ) of the knee extensor ( KE ) muscles on muscle function , functional limitations , and self-reported disability . METHODS The authors conducted a single-blinded , r and omized , placebo-controlled trial . Twenty-two institutionalized elders ( mean age , 81.5 years ) were assigned to either high-intensity strength training ( HI ; n = 8) , low-moderate intensity strength training ( LI ; n = 6 ) , or weight-free placebo-control training ( PC ; n = 8) . The HI group trained at 80 % of their 1-repetition maximum and the LI group trained at 40 % . All groups performed 3 sets of 8 repetitions , 3 times per week for 10 weeks . Outcome measures included KE maximal strength , KE endurance , and functional performance as assessed by 6-minute walking , chair-rising , and stair-climbing tests , and by self-reported disability . RESULTS KE strength and endurance , stair-climbing power , and chair-rising time improved significantly in the HI and LI groups compared with the PC group . Six-minute walking distance improved significantly in the HI group but not in the LI group compared with the PC group . Changes observed in HI were significantly different from those observed in the LI group for KE strength and endurance and the 6-minute walking test , with a trend in the same direction for chair-rising and stair-climbing . Changes in strength were significantly related to changes in functional outcomes , explaining 37 % to 61 % of the variance . CONCLUSIONS These results show strong dose-response relationships between resistance training intensity and strength gains , and between strength gains and functional improvements after resistance training . Low-moderate intensity resistance training of the KE muscles may not be sufficiently robust from a physiologic perspective to achieve optimal improvement of functional performance . Supervised HI , free weight-based training for frail elders appears to be as safe as lower intensity training but is more effective physiologically and functionally | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,406 | 16,609,319 | A network-based geriatric rehabilitation programme: study design and baseline characteristics of the patients | The objective of this paper is to present the design and participants of an ongoing r and omized controlled trial on a network-based geriatric rehabilitation programme , targeted at frail elderly persons with progressively declining health and a high risk of institutionalization . Forty-one municipalities , seven rehabilitation centres and a total of 741 frail elderly ( 65+years ) community-living persons participated in the study . Assessment s included measurements of physical capacity ( balance , h and grip strength , walking speed ) , Functional Independence Measure , Geriatric Depression Scale , 15 Dimension quality of life question naire and Mini Mental State Examination . Question naires covered physical , social and psychological factors . The participants were old ( mean age 78 years , range 65–96 ) and mainly female ( 86 % ) . They were physically frail and most of them ( 66 % ) had experienced deterioration of health within 1 year . The majority lived alone ( 72 % ) and received regular help from other people ( 99 % ) . The mean Mini Mental State Examination and Geriatric Depression Scale scores were 25.2 and 4.1 points , respectively . Depressive mood ( Geriatric Depression Scale>6 points ) was found in 17 % and declined cognitive function ( Mini Mental State Examination<24 points ) in 28 % of the participants . Differences between the r and omized intervention and control groups were insignificant . Since the number of participants is sufficient statistically , the prospect s for evaluating the effectiveness of the programme , and identifying potential benefactors , are good . Die vorliegende wissenschaftliche Veröffentlichung möchte den Aufbau und die Teilnehmer einer fortlaufenden r and omisierten kontrollierten Studie einem netzwerkbasierten Reha-Programm präsentieren , das auf gebrechliche ältere Menschen mit progressivem körperlichen Verfall und einem hohen Risiko der Institutionalisierung abzielt . An dieser Studie nahmen 41 Stadtverwaltungen , sieben Reha-Zentren und insgesamt 741 gebrechliche ältere Menschen ( 65 + Jahre ) aus der Gemeinde teil . Durchgeführt wurden u. a. Messungen der körperlichen Leistungsfähigkeit ( Gleichgewicht , Stärke des Händedrucks , Gehgeschwindigkeit ) , der funktionalen Selbständigkeit sowie Untersuchungen anh and der Geriatric Depression Scale ( GDS ) und des 15-teiligen Fragebogens zur Lebensqualität und der Mini Mental State Examination . Die Fragebögen befassten sich mit körperlichen , sozialen und psychologischen Faktoren . Die Teilnehmer waren alt ( Durchschnittsalter von 78 Jahren , Altersspanne von 65–96 Jahren ) und vorwiegend Frauen ( 86 % ) . Sie waren körperlich gebrechlich , und bei den meisten von ihnen ( 66 % ) war innerhalb von einem Jahr eine gesundheitliche Verschlechterung beobachtet worden . Die meisten lebten allein ( 72 % ) und erfuhren regelmäßig Unterstützung ( 99 % ) . Die durchschnittlichen Werte anh and der Mini Mental State Examination und der Geriatric Depression Scale lagen bei 25.2 bzw . 4.1 Punkten . Depressionen ( Geriatric Depression Scale>6 Punkte ) lagen bei 17 % und eine verminderte kognitive Funktion ( Mini Mental State Examination<24 Punkte ) bei 28 % der Teilnehmer vor . Die Unterschiede zwischen der r and omisierten Interventions - und der Kontrollgruppe waren unwesentlich . Da die Anzahl der Teilnehmer statistisch betrachtet gering ist , sind die Aussichten für die Bewertung der Wirksamkeit des Programms und für die Ermittlung potenzieller Nutznießer gut . El objetivo de este estudio es presentar el diseño , y a los participantes , de un estudio clínico comparativo aleatorizado sobre un programa en red de rehabilitación geriátrica , diseñado para pacientes ancianos frágiles cuya salud se deteriora de manera progresiva y que presentan un alto riesgo de necesitar hospitalización . En el estudio participaron 41 municipalidades , siete centros de rehabilitación y un total de 741 ancianos ( de más de 65 años de edad ) frágiles que viven en la comunidad . Se utilizaron la evaluación de la capacidad física ( equilibrio , presión de agarre en las manos , velocidad al caminar ) , la Medida de Independencia Funcional , la Escala de Depresión Geriátrica , el cuestionario Dimensión 15 sobre la calidad de vida y la Mini Evaluación del Estado Mental . Los cuestionarios exploraron factores físicos , sociales y sicológicos . Los participantes fueron ancianos ( de más de 78 años de edad , de un intervalo de 65 a 96 ) y principalmente mujeres ( 86 % ) . Todos presentaban fragilidad física y la salud de la mayoría de ellos ( 66 % ) se había deteriorado en el último año . La mayoría vivía solo ( 72 % ) y recibía ayuda de otras personas ( 99 % ) . Las puntuaciones medias obtenidas mediante la Mini Evaluación del Estado Mental y la Escala de Depresión Geriátrica fueron de 25.2 y 4.1 puntos , respectivamente . Se constataron sentimientos depresivos ( Escala de Depresión Geriátrica>6 puntos ) en el 17 % de los participantes y disminución en las funciones cognitivas ( Mini Evaluación del Estado Mental<24 puntos ) en el 28 % de ellos . Las diferencias entre la intervención aleatorizada y los grupos de referencia no fueron significativas . Debido a que desde el punto de vista estadístico el número de participantes fue suficiente , la posibilidad de evaluar la eficacia del programa e identificar sus posibles beneficios es buena . Ce document a pour objectif de présenter la conception et les participants à des essais contrôlés , r and omisés et continus pour un programme de rééducation gériatrique s'adressant aux personnes âgées et fragilisées do nt la santé décline progressivement et présentant un risque de totale dépendance . Quarante et une municipalités , sept centres de rééducation et un total de 741 personnes âgées fragiles ( 65 + ans ) vivant dans la collectivité ont participé à l'étude . Parmi les données évaluées , citons la capacité physique ( équilibre , force de préhension , vitesse de marche ) , l'indépendance fonctionnelle , l'échelle de dépression gériatrique , un question naire de qualité de la vie en 15 dimensions et l'examen Mini Mental State . Les question naires portaient sur des facteurs physiques , sociaux et psychologiques . Les participants étaient âgés ( âge moyen 78 ans , fourchette 65–96 ans ) et principalement féminins ( 86 % ) . Ils étaient physiquement fragiles et la plupart d'entre eux ( 66 % ) avait subi une détérioration de leur santé au cours de l'année passée . La majorité vivait seule ( 72 % ) et recevait régulièrement de l'aide ( 99 % ) . Les scores moyens pour l'examen Mini Mental State et la chaîne de dépression gériatrique s'élevaient respectivement à 25.2 et 4.1 points . L'humeur dépressive ( échelle de dépression gériatrique > 6 points ) a été identifiée dans 17 % des cas et un déclin des fonctions cognitives ( examen Mini Mental State < 24 points ) chez 28 % des participants . Les différences entre les interventions r and omisées et les groupes contrôlés étaient insignifiantes . Dans la mesure où le nombre de participants est statistiquement suffisant , les perspectives d'évaluation de l'efficacité du programme et d ' identification des bénéficiaires potentiels sont bonnes | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,407 | 14,586,908 | Two years later: a prospective long-term follow-up of a training intervention in geriatric patients with a history of severe falls. | OBJECTIVE To study the long-term outcome of a physical training regimen of ambulant postward rehabilitation in community-dwelling geriatric patients with a history of injurious falls . DESIGN Prospect i ve 2-year follow-up of a r and omized placebo-controlled intervention trial . SETTING Postward rehabilitation in a geriatric hospital in Germany . PARTICIPANTS Fifty-seven geriatric patients ( mean age , 84.3+/-4.4 y ) with a history of severe falls . INTERVENTION Ambulatory training of strength , functional performance , and balance 3 times a week for 3 months for 31 patients versus placebo activities for 26 patients . MAIN OUTCOME MEASURES Strength , functional performance , fall-related psychologic parameters , and physical activity assessed by st and ardized protocol s 2 years after the training intervention , compared with baseline results . RESULTS Motor performance decreased substantially in both groups . As patients in the intervention group declined from significantly improved motor performance levels achieved in the initial training intervention , differences between the groups were still significant in most functional performances 2 years later . Functional decline was greater in persons who were institutionalized or being cared for by family members . Physical activity , which increased during the exercise intervention , returned to low baseline levels . CONCLUSIONS Improved functional performance in the training group did not lead to an increased level of physical activity after training , which might have preserved the functional improvements . In mobility-restricted , frail , geriatric patients such as our study population , training programs should continue to keep patients active and to prevent the decline in strength and functional performance that precedes loss of autonomy | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,408 | 15,575,122 | Effects of a fall prevention program including exercise on mobility and falls in frail older people living in residential care facilities | Background and aims : Impaired mobility is one of the strongest predictors for falls in older people . We hypothesized that exercise as part of a fall prevention program would have positive effects , both short- and long-term , on gait , balance and strength in older people at high risk of falling and with varying levels of cognition , residing in residential care facilities . A secondary hypothesis was that these effects would be associated with a reduced risk of falling . Methods : 187 out of all residents living in 9 facilities , ≥65 years of age were at high risk of falling . The facilities were clusterr and omized to fall intervention or usual care . The intervention program comprised : education , environment , individually design ed exercise , drug review , post-fall assessment s , aids , and hip protectors . Data were adjusted for baseline performance and clustering . Results : At 11 weeks , positive intervention effects were found on independent ambulation ( FAC , p=0.026 ) , maximum gait speed ( p=0.002 ) , and step height ( ≥10 cm , p<0.001 ) , but not significantly on the Berg Balance Scale . At 9 months ( long-term outcome ) , 3 intervention and 15 control residents had lost the ability to walk ( p=0.001 ) . Independent ambulation and maximum gait speed were maintained in the intervention group but deteriorated in the control group ( p=0.001 ) . Residents with both higher and lower cognition benefited in most outcome measures . No association was found between improved mobility and reduced risk of falling . Conclusions : Exercise , as part of a fall prevention program , appears to preserve the ability to walk , maintain gait speed , ambulate independently , and improve step height . Benefits were found in residents with both lower and higher cognitive impairment , but were not found to be associated with a reduced risk of falling | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,409 | 12,752,837 | Fall and injury prevention in residential care--effects in residents with higher and lower levels of cognition. | OBJECTIVES To evaluate the effectiveness of a multifactorial fall and injury prevention program in older people with higher and lower levels of cognition . DESIGN A preplanned subgroup comparison of the effectiveness of a cluster-r and omized , nonblinded , usual-care , controlled trial . SETTING Nine residential facilities in Umeå , Sweden . PARTICIPANTS All consenting residents living in the facilities , aged 65 and older , who could be assessed using the Mini-Mental State Examination ( MMSE ; n = 378 ) . An MMSE score of 19 was used to divide the sample into one group with lower and one with higher level of cognition . The lower MMSE group was older ( mean + /- st and ard deviation = 83.9 + /- 5.8 vs 82.2 + /- 7.5 ) and more functionally impaired ( Barthel Index , median ( interquartile range ) 11 ( 6 - 15 ) vs 17 ( 13 - 18 ) ) and had a higher risk of falling ( 64 % vs 36 % ) than the higher MMSE group . INTERVENTION A multifactorial fall prevention program comprising staff education , environmental adjustment , exercise , drug review , aids , hip protectors , and postfall problem-solving conferences . MEASUREMENTS The number of falls , time to first fall , and number of injuries were evaluated and compared by study group ( intervention vs control ) and by MMSE group . RESULTS A significant intervention effect on falls appeared in the higher MMSE group but not in the lower MMSE group ( adjusted incidence rates ratio of falls P = .016 and P = .121 and adjusted hazard ratio P < .001 and P = .420 , respectively ) . In the lower MMSE group , 10 femoral fractures were found , all of which occurred in the control group ( P = .006 ) . CONCLUSION The higher MMSE group experienced fewer falls after this multifactorial intervention program , whereas the lower MMSE group did not respond as well to the intervention , but femoral fractures were reduced in the lower MMSE group | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,410 | 16,108,924 | Functional incidental training: a randomized, controlled, crossover trial in Veterans Affairs nursing homes. | OBJECTIVES To test the effects of a rehabilitative intervention directed at continence , mobility , endurance , and strength ( Functional Incidental Training ( FIT ) ) in older patients in Department of Veterans Affairs ( VA ) nursing homes . DESIGN R and omized , controlled , crossover trial . SETTING Four VA nursing homes . PARTICIPANTS All 528 patients in the nursing homes were screened ; 178 were eligible , and 107 were r and omized to an immediate intervention group ( Group 1 ; n=52 ) and a delayed intervention group ( Group 2 ; n=55 ) . INTERVENTION Trained research staff provided the FIT intervention , which included prompted voiding combined with individualized , functionally oriented endurance and strength-training exercises offered four times per day , 5 days per week , for 8 weeks . Group 1 received the intervention while Group 2 served as a control group ; then Group 2 received the intervention while Group 1 crossed over to no intervention . A total of 64 subjects completed the intervention phase of the trial . MEASUREMENTS Timed measures of walking or wheeling a wheelchair ( mobility ) , sit-to-st and exercises , independence in locomotion and toileting as assessed using the Functional Independence Measure ( FIM ) , one-repetition maximum weight for several measures of upper and lower body strength , frequency of urine and stool incontinence , and appropriate toileting ratios . RESULTS There was a significant effect of the FIT intervention on virtually all measures of endurance , strength , and urinary incontinence but not on the FIM for locomotion or toileting . The effects of FIT were observed when Group 1 received the intervention and was compared with the control group and when Group 2 crossed over to the intervention . Group 1 deteriorated in all measures during the 8-week crossover period . Within-person comparisons also demonstrated significant effects on all measures in the 64 participants who completed the intervention ; 43 ( 67 % ) of these participants were " responders " based on maintenance or improvement in at least one measure of endurance , strength , and urinary incontinence . No adverse events related to FIT occurred during the study period . CONCLUSION FIT improves endurance , strength , and urinary incontinence in older patients residing in VA nursing homes . Translating these positive benefits achieved under research conditions into practice will be challenging because of the implication s of the intervention for staff workload and thereby the costs of care | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,411 | 10,418,398 | The value of strength training for older adults. | Health in older adults can best be measured in terms of functional status . Skeletal muscle strength has been reported to be a determinant of functional status in older individuals . Two major contributors to the decline in muscle function as a person ages are disuse and physical inactivity . Declining muscle function through a loss of muscular strength may decrease functional independence and mobility and increase the risk for falls and injuries , physical frailty , and disability . Older individuals lacking an appropriate amount of muscular strength may not be able to perform various activities of daily living , which are important indicators of independence | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,412 | 14,687,345 | The effect of group exercise on physical functioning and falls in frail older people living in retirement villages: a randomized, controlled trial. | OBJECTIVES To determine whether a 12-month program of group exercise can improve physical functioning and reduce the rate of falling in frail older people . DESIGN Cluster r and omized , controlled trial of 12 months duration . SETTING Retirement villages in Sydney and Wollongong , Australia . PARTICIPANTS Five hundred fifty-one people aged 62 to 95 ( mean+/-st and ard deviation=79.5+/-6.4 ) who were living in self- and intermediate-care retirement villages . MEASUREMENTS Accidental falls , choice stepping reaction time , 6-minute walk distance postural sway , leaning balance , simple reaction time , and lower-limb muscle strength . RESULTS Two hundred eighty subjects were r and omized to the weight-bearing group exercise ( GE ) intervention that was design ed to improve the ability of subjects to undertake activities for daily living . Subjects r and omized to the control arm ( n=271 ) attended flexibility and relaxation ( FR ) classes ( n=90 ) or did not participate in a group activity ( n=181 ) . In spite of the reduced precision of cluster r and omization , there were few differences in the baseline characteristics of the GE and combined control ( CC ) subjects , although the mean age of the GE group was higher than that of the CC group , and there were fewer men in the GE group . The mean number of classes attended was 39.4+/-28.7 for the GE subjects and 31.5+/-25.2 for the FR subjects . After adjusting for age and sex , there were 22 % fewer falls during the trial in the GE group than in the CC group ( incident rate ratio=0.78 , 95 % confidence interval (CI)=0.62 - 0.99 ) , and 31 % fewer falls in the 173 subjects who had fallen in the past year ( incident rate ratio=0.69 , 95 % CI=0.48 - 0.99 ) . At 6-month retest , the GE group performed significantly better than the CC group in tests of choice stepping reaction time , 6-minute walking distance , and simple reaction time requiring a h and press . The groups did not differ at retest in tests of strength , sway , or leaning balance . CONCLUSION These findings show that group exercise can prevent falls and maintain physical functioning in frail older people | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,413 | 14,963,375 | Changes in Postural Balance in Frail Elderly Women during a 4-Week Visual Feedback Training: A Randomized Controlled Trial | Background : Balance training programs have not shown consistent results among older adults , and it remains unclear how different training methods can be adapted to frail elderly people . Objective : The purpose of this study was to investigate the effects of a 4-week visual feedback-based balance training on the postural control of frail elderly women living in residential care homes . Methods : Elderly women of two residential care facilities were r and omized to an exercise group ( EG , n = 20 ) and to a control group ( CG , n = 7 ) . The EG participated in training sessions three times/week for 4 weeks . The exercises were carried out with a computerized force platform with visual feedback screen . The dimensions of balance function studied were st and ing body sway , dynamic weight shifting , and Berg Balance Scale performance . Results : The EG showed significant improvement in balance functions . The performance time in dynamic balance tests improved on average by 35.9 % compared with a 0.6 % increase in the CG ( p = 0.025–0.193 ) . The performance distance in these tests decreased on average by 28.2 % in the EG as compared with a 9.8 % decrease seen in the CG . The Berg Balance Scale performance improved by 6.9 % compared with a 0.7 % increase in the CG ( p = 0.003 ) . The st and ing balance tests in the more dem and ing st and ing positions showed improvements in the EG , whereas similar changes in the CG were not found . Conclusions : Our findings suggest that balance training based on visual feedback improves the balance control in frail elderly women living in residential care , also enhancing the performance of functional balancing tasks relevant to daily living . The subjects were motivated to participate in the training , as indicated by the high compliance ( 97.5 % ) with the program | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,414 | 8,185,457 | Improvements in quadriceps strength with regular seated exercise in the institutionalized elderly. | The quadriceps strength of a group of residents homes for the elderly ( mean age 83 years ) was assessed in a r and omized controlled trial of seated group exercise versus group reminiscence therapy . Fifty-five of 65 volunteers completed the 6-month study , with 4 dropouts from the exercise group , and 6 dropouts from the reminiscence group . There were no adverse effects . Average of attendance at the exercise sessions was 72 % ( range , 18 % to 98 % ) and 62 % ( range , 29 % to 100 % ) at the reminiscence sessions . The reminiscence sessions comprised group interaction and discussion prompted by the use of reminiscence aids . By the end of the study , the change observed in the exercise group was significantly different from the reminiscence group in terms of quadriceps strength ( p < 0.01 , Mann-Whitney U test ) . Both groups improved equally in their ability to climb up steps , but neither cognitive function ( Mini-Mental State Examination ) nor reaction time altered significantly | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,415 | 12,807,578 | Effectiveness of a group exercise program in a long-term care facility: a randomized pilot trial. | OBJECTIVE The purpose of this pilot was to determine whether a strength and flexibility program in frail long-term care facility ( LTC ) residents would result in improved function . DESIGN A prospect i ve , r and omized , controlled , semicrossover trial was design ed with participants assigned either to group exercise ( EX ) or recreational therapy ( C ) . In the EX group , the intervention continued for 1 year . In the C group , recreation continued for 6 months ; these controls were then crossed over to the same exercise intervention as the EX group and followed for an additional 6 months . Functional outcomes were measured at baseline and 3 , 6 , 9 , and 12 months for both groups . SETTING A LTC facility , which included both assisted living ( AL ) and nursing home ( NH ) residents . PARTICIPANTS Twenty frail residents ( 5 from NH , 15 from AL ) aged 75 to 99 years at one LTC facility . INTERVENTION After r and om group assignment , the EX group met 1 hour three times per week . An exercise physiologist and LTC staff conducted sessions which included seated range of motion ( ROM ) exercises and strength training using simple equipment such as elastic resistance b and s ( therab and s ) and soft weights . The C group met three times per week and participated in activities such as painting during the first 6 months , before crossing over to exercise . MEASUREMENTS AND METHODS Objective measures of physical and cognitive function were obtained at baseline and 3 , 6 , 9 , and 12 months using the timed get-up- and -go test ( TUG ) , Berg balance scale , physical performance test ( PPT ) , and mini-mental status exam ( MMSE ) . Because we were interested in the impact of exercise on multiple endpoints and to protect the type I error rate , a global hypothesis test was used . RESULTS There was a significant overall impact across the four measures of the exercise intervention ( P = 0.013 ) . Exercise benefit as indicated by the difference between exercise and control conditions showed exercise decreased TUG by 18 seconds , which represents an effect size ( in st and ard deviation units ) of 0.50 , increased PPT scores by 1.3 , with effect size = 0.40 , increased Berg scores by 4.8 , with effect size of 0.32 , and increased MMSE by 3.1 , with effect size = 0.54 . Except for the Berg , 90 % confidence intervals on these exercise effects excluded 0 . CONCLUSION Frail elderly in a LTC facility were able to participate and benefit from a strength training program . The program was delivered with low-cost equipment by an exercise physiologist and LTC staff . The advantage of such a program is that it provides recreational and therapeutic benefits | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,416 | 10,724,076 | Exercise training in the debilitated aged: strength and functional outcomes. | OBJECTIVE Resistance and endurance training result in gains in fitness in the aged . It is unclear whether the debilitated elderly can perform moderate-intensity training and whether such training results in short-term improvements in strength , endurance , and function in this population . DESIGN R and omized , controlled trial . SETTING S AND PATIENTS Subjects were from a Veterans Affairs nursing home and rehabilitation unit and a community nursing home . They were older than 60 yrs with impairment in at least one physical activity of daily living . Seventy-eight subjects volunteered and 58 ( mean age , 75 yrs ; 9 women , 49 men ) completed the intervention and initial posttest . Only one subject withdrew because of injury or disinterest . INTERVENTION Thrice-weekly resistance training ( using an isokinetic dynamometer ) and twice-weekly endurance training for 4 to 8 weeks . MAIN OUTCOMES Isometric strength in dominant arm and leg , heart rate response to timed endurance test , and activities of daily living score . RESULTS The mean change in isometric strength across the muscle movements tested was 32.8 % in the training group and 10.2 % in the control group ( difference , 22.6 % ; 95 % confidence interval , 6.2 % to 39.0 % ) . No change in heart rate during exercise was seen in the training group . Trained subjects tended to have a greater improvement in functional activity than control subjects , which was statistically significant ( p = .04 ) for those subjects who at enrollment were most dysfunctional ( i.e. , activities of daily living score less than 13 [ maximum score 26 ] ) . CONCLUSION This group of debilitated elderly patients effectively performed resistance training and increased their strength , with the most impaired gaining the most function . Few in the group could effectively perform endurance training | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,417 | 12,020,141 | Fall and Injury Prevention in Older People Living in Residential Care Facilities: A Cluster Randomized Trial | Context In frail older people living in residential care facilities , hip protectors reduce fall-related femoral and pelvic injuries . In older people living in the community , prevention programs that target exercise and fall-related risk factors reduce falls and injuries . In older people living in residential care facilities , fall prevention programs , other than the use of hip protectors , have had mixed results . Contribution This r and omized trial shows that a multidisciplinary fall prevention program reduces falls and femoral fractures in older people living in residential care facilities . The program included general as well as resident-specific , tailored strategies . Editors ' Note The Cochrane Library ( Issue 3 , 2001 ) has two systematic review s that summarize r and omized trial evidence about interventions to prevent falls . The Editors Falls are a major problem in older people ( 1 , 2 ) . Hip fractures result ing from falls are particularly common in elderly persons living in residential care facilities ( 3 , 4 ) ; they account for a substantial proportion of dependency and mortality ( 5 ) . During the past decade , r and omized , controlled trials study ing fall prevention have shown both positive and negative results ( 6 - 8 ) . Differences in target groups , interventions , and outcome measures may explain the inconsistent results . In residential care facilities and nursing homes , only one trial demonstrated that intervention programs may help prevent falls ; however , this trial studied only people who fell repeatedly ( 9 ) . Other trials have not shown reductions in falls or injuries ( 10 - 13 ) but have shown fewer hospital admissions ( 11 ) and improvements in mobility ( 12 ) , visual acuity , and hypotension ( 13 ) . The use of hip protectors has consistently proved effective in preventing hip fractures in selected high-risk population s ( 14 ) . Some trials that have included cognitively healthier older people in the community have shown reduced falls and injuries when specific risk factors are targeted ( 15 - 18 ) . However , evidence is lacking for older people living in institutions ( 19 ) . We hypothesized that an intervention program that targeted multiple risk factors for falls in older people living in residential care facilities , in particular those with a high risk for falling , would reduce falls and fall-related injuries . We therefore conducted a cluster r and omized trial for preventing falls in nine residential care facilities . Methods Design Study participants were older people living in residential care facilities located in Ume , a city in northern Sweden . The selected facilities had to have more than 25 residents . The nine that met this criterion were divided into group A and group B. The distribution was based on the age and number of residents , type of setting ( care and service offered as well as corridor or private home design ) , and record of previous falls as routinely reported to the local authority . To keep the groups distinct from one another , the physicians , registered nurses , physical therapists , and occupational therapists who were responsible for working with the residents in group A could not also work with group B residents . Group A consisted of four facilities that accommo date d 224 residents ; the facilities had 29 to 74 residents each , and the median age by facility ranged from 82 to 85 years . Group B consisted of five facilities with a total of 215 residents ; there were 31 to 66 residents per facility , and the median age by facility ranged from 79 to 85 years . The number of falls reported to the local authorities in the 2.5 years preceding the trial was similar for both groups : 1.26 per resident per year for group A and 1.29 for group B. After baseline assessment of all residents , groups A and B were r and omly assigned by lots to an intervention or a control group ( Figure 1 ) . The r and om allocation was conducted by a person with no knowledge of the study . Two sealed , dark envelopes were used . In each envelope , a letter specified one of the groups . Before the lot was drawn , the first envelope drawn was design ated as the intervention group . The local authorities , residents , staff of the nine facilities , and the research group were then informed of the results of the r and omization . Figure 1 . Study design . All residents in the study received written and oral information . All participants ( or the relatives and guardians of participants with severe cognitive dysfunction ) gave informed consent . The administrators and staff of the nine facilities involved also received information about the study and agreed to participate . The Ethics Committee of the Medical Faculty of Ume University approved the study . Definition of a Fall and an Injury A fall was defined as an event in which the resident unintentionally came to rest on the ground or floor , regardless of whether an injury was sustained . Thus , this definition also includes falls that result ed from acute illness or epileptic seizure and incidents that result ed in a resident 's falling and being found on the floor by staff or another resident . An injury was defined according to the Abbreviated Injury Scale ( 20 ) . Classifications were minor for injuries limited to superficial wounds and bruises ; moderate for intermediate-level injuries , such as vertebral and wrist fractures ; and serious for major fractures , such as hip fractures and other femoral fractures . Participants and Setting s All residents in the nine facilities who were 65 years of age or older were selected in a cross-sectional manner . Thirty-seven of these residents declined to participate , were admitted to hospitals , or died before r and omization . Sex and age of the 37 non participants were similar to those of the remaining 402 residents . In Sweden , older people living in residential care facilities are disabled by cognitive or physical impairment and thus require supervision , functional support , or nursing care . In this study , some residents lived in private apartments and others had private rooms but shared dining and living rooms . In all facilities , residents had 24-hour daily access to assistance with activities of daily living , household issues , and medical care . The median age was 83 years ( range , 65 to 100 years ) , and most residents were female ( 72 % ) . Few residents could walk outdoors without a walking aid ( 14 % ) or shower without assistance ( 18 % ) ; few were nonambulatory ( 19 % ) or entirely dependent when eating ( 8 % ) . Additional baseline characteristics are presented in the Table . Table . Baseline Characteristics of the 402 Residents Participating in the Study All members of the permanent staff , regardless of profession , participated in the study . In addition , eight physiotherapists were employed part-time ( a total of 200 h/wk ) until the end of the intervention period , and three physiotherapists were employed part-time ( a total of 10 h/wk ) during the follow-up period . A total of 273 nurses ' aides or licensed practical nurses and 20 registered nurses worked at the nine facilities . Baseline Assessment Each resident 's physician completed a question naire regarding clinical characteristics and drugs prescribed . A registered nurse reported delirium episodes ( Table ) . Physiotherapists interviewed and assessed all residents . Hearing was rated as impaired if the resident could not hear normal speech from a distance of 1 meter or used a hearing aid . Vision was rated as impaired when the resident , with or without glasses , could not read a word written in 5-mm capital letters at reading distance . Global cognitive function was screened by using the Mini-Mental State Examination ( MMSE ) ( 21 ) . Licensed practical nurses or nurses ' aides were interviewed to determine the number of falls that had occurred during the 6 months preceding the study and the extent of use of physical restraints . Activities of daily living were assessed according to the Barthel index ( 22 , 23 ) . All residents were screened for the risk for falling . First , by using the Mobility Interaction Fall Chart ( 24 ) , a resident was classified to be at higher risk for falling if he or she stopped walking when talking to an accompanying person ( 25 ) , walked more slowly when carrying a glass of water ( 26 ) , or had impaired vision or difficulty concentrating . Second , a physiotherapist globally rated the fall risk as higher if the resident showed risk-taking behavior considered to jeopardize balance . If the residents were not classified to be at higher risk for falling by any of these described measures , they were considered to be at lower risk for falling . Residents at higher risk were likely to be older than those at lower risk ( median age , 84 years [ range , 65 to 98 years ] vs. 83 years [ range , 65 to 100 years ] ) , to have lower MMSE scores ( median score , 17 [ range , 0 to 30 ] vs. 21 [ range , 0 to 30 ] ) , and to have more medical diagnoses ( median , 4 vs. 3 ) . The main areas of each facility were also screened according to a checklist for environmental hazards , such as lighting , flooring , obstacles inside the facility , and dangerous areas outside the facility ( for example , icy areas ) . Twelve residents in the control group and six in the intervention group died or moved during the 11-week intervention period ( Figure 1 ) . Intervention Program The intervention program comprised strategies that targeted both general and resident-specific risk factors for falling . The strategies were design ed to be meaningful to the residents without compromising mobility . The 89 residents screened as being at higher risk as well as the 19 residents at lower risk who fell during the 11-week intervention period were the focus of the individualized intervention program . Increasing the staff 's knowledge about fall prevention was believed to be the starting point of a process that would produce long-term results . Staff Education All staff were invited to a 4-hour educational session , and more than half attended . The sessions were led by a physician and a physiotherapist and covered risk factors for falls and intervention | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,418 | 15,207,420 | Physical activity and behavior in the elderly: a pilot study. | Although exercise is usually promoted for weight loss and better heart health , there is growing evidence that regular physical activity helps people preserve their mental ability . We describe the results of a pilot longitudinal study addressing the impact of a moderate intensity exercise program on behavioral problems of frail , elderly , demented patients living in nursing home . Overall , patients in the treatment group ( combination of aerobic/endurance activities , strength training , balance , and flexibility training ) showed a statistically significant reduction in the behavioral problems , such as w and ering , physical and verbal abuse , and in the sleep disorders . As a consequence , a significant reduction in the use of antipsychotic and hypnotic medications was observed in subjects of the treated group . In conclusion , our preliminary results suggest that engaging in regular physical activity , among other health benefits , may delay or prevent the onset of behavior problems in demented frail elderly people living in nursing home | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,419 | 11,777,093 | Effect of a physical therapeutic intervention for balance problems in the elderly: A single-blind, randomized, controlled multicentre trial | Objective : To establish the effect of a short , individualized exercise programme on balance dysfunction in the elderly . Design : A single-blind , r and omized , controlled , multicentre trial . Setting : Physical and recreational therapy departments from two rehabilitation centres . Participants : Ninety-four subjects of ≥75 years with functional balance problems living independently or in a residential care facility . Seventy-seven subjects completed the intervention period and four-week follow-up . At a one-year follow-up 49 subjects were evaluated on balance functioning . Interventions : Twelve sessions of an individualized balance training programme ( experimental group ) or 12 sessions of an individualized extra attention programme ( control group ) given in 4–6 weeks . Main outcome measures : Berg Balance Scale and the Dynamic Gait Index to establish balance functioning , a visual analogue scale to establish fear of falling in daily life and the Hospital Anxiety Depression Scale to verify feelings of anxiety and depression . Results : Subjects in the experimental group improved significantly more on the Berg Balance Scale and the Dynamic Gait Index than those in the control group ( p ≤ 0.001 , p ≤ 0.001 , respectively ) . However the effect disappeared at a one-year follow-up on the Berg Balance Scale . No prognostic factors could be identified to determine who would benefit most from the individualized exercise programme . Results on the other response variables revealed no effect of the intervention . Conclusion : A short individualized exercise programme can improve functional balance in people aged 75 years and older . This improvement was maintained at least for one month but had worn off by one year | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,420 | 12,825,328 | Training for muscle power in older adults: effects on functional abilities. | The purpose of this study was to determine the influence of simple , progressive lower body exercise training , focusing on strength and power , on functional abilities in frail older adults . Twenty-five residents of a long-term care facility ( 75 - 94 yrs ) participated in this r and omized controlled trial of 10-wks duration . The exercise group ( Ex , n = 18 ) underwent simple , progressive lower body resistance exercises , specifically aim ed at improving muscle power , 3 times/wk ; the control subjects ( Con , n = 7 ) maintained their usual daily activities . Knee extensor strength and power were measured on an isokinetic dynamometer ( 180 degrees/s ) , and functional performance was assessed from a 6-m walk timed test , a 30-s chair st and , and an 8-ft up- and -go timed test , before and after the 10-wk intervention period . Significant increases were found in the Ex group for eccentric ( 44 % ) and concentric ( 60 % ) average power ( p < 0.05 ) , and improvements were seen on each functional test : the 8-foot up- and -go , chair st and , and walk time improved by 31 % , 66 % , and 33 % , respectively ( p < 0.05 ) . No significant change occurred in the Con group . In conclusion , simple progressive exercise training , even in the 10th decade , increases muscle power and is associated with an improved performance of functional activities using the trained muscles | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,421 | 14,991,552 | An exercise program to improve fall-related outcomes in elderly nursing home residents. | This study tested a 3-month ankle-strengthening and walking program design ed to improve or maintain the fall-related outcomes of balance , ankle strength , walking speed , risk of falling , fear of falling , and confidence to perform daily activities without falling ( falls efficacy ) in elderly nursing home residents . Nursing home residents ( N = 81 ) between the ages of 64 and 100 years participated in the study . Two of the fall-related outcomes , balance and fear of falling , were maintained or improved for the exercise group in comparison to the control group | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,422 | 8,190,152 | Exercise training and nutritional supplementation for physical frailty in very elderly people. | BACKGROUND Although disuse of skeletal muscle and undernutrition are often cited as potentially reversible causes of frailty in elderly people , the efficacy of interventions targeted specifically at these deficits has not been carefully studied . METHODS We conducted a r and omized , placebo-controlled trial comparing progressive resistance exercise training , multinutrient supplementation , both interventions , and neither in 100 frail nursing home residents over a 10-week period . RESULTS The mean ( + /- SE ) age of the 63 women and 37 men enrolled in the study was 87.1 + /- 0.6 years ( range , 72 to 98 ) ; 94 percent of the subjects completed the study . Muscle strength increased by 113 + /- 8 percent in the subjects who underwent exercise training , as compared with 3 + /- 9 percent in the nonexercising subjects ( P < 0.001 ) . Gait velocity increased by 11.8 + /- 3.8 percent in the exercisers but declined by 1.0 + /- 3.8 percent in the nonexercisers ( P = 0.02 ) . Stair-climbing power also improved in the exercisers as compared with the nonexercisers ( by 28.4 + /- 6.6 percent vs. 3.6 + /- 6.7 percent , P = 0.01 ) , as did the level of spontaneous physical activity . Cross-sectional thigh-muscle area increased by 2.7 + /- 1.8 percent in the exercisers but declined by 1.8 + /- 2.0 percent in the nonexercisers ( P = 0.11 ) . The nutritional supplement had no effect on any primary outcome measure . Total energy intake was significantly increased only in the exercising subjects who also received nutritional supplementation . CONCLUSIONS High-intensity resistance exercise training is a feasible and effective means of counteracting muscle weakness and physical frailty in very elderly people . In contrast , multi-nutrient supplementation without concomitant exercise does not reduce muscle weakness or physical frailty | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,000 | 20,881,587 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . | 48,423 | 16,426,800 | Once a week not enough, twice a week not feasible? A randomised controlled exercise trial in long-term care facilities [ISRCTN87177281]. | OBJECTIVE To evaluate the effectiveness of three different training protocol s on physical function of older adults living in long-term care facilities . Emphasis was placed on feasibility in real-life situations . METHODS Subjects ( N=224 ) were r and omised to 6 months of twice weekly ( 1 ) resistance training ; ( 2 ) all-round functional-skills training ; ( 3 ) a combination of both ; or ( 4 ) a control program . Fitness and performance measures and self-reported disability were measured at baseline and after 24 weeks intervention . RESULTS Attendance to the strength training was 76 % , to the functional-skills training 70 % and to the combined training 73 % . In those who attended at least 75 % of all classes ( n=97 ) the functional-skills and combined training program improved several fitness and performance measures compared to the control group . CONCLUSION Twice weekly functional-skills training , or a combination of resistance and functional-skills training can improve several fitness and performance measures of institutionalised older people . PRACTICE IMPLICATION S An important finding from our study was that less than twice a week exercise training is not enough for functional improvement , while it proved difficult for the elderly subjects to exercise twice weekly . Education on the health benefits of regular exercise , and a larger availability of classes in long-term care facilities may improve attendance | 2,000 | The conclusion is that there is firm evidence for training effects on physical fitness , functional performance , activity of daily living performance , and quality -of-life . | The objective of this study was to perform a systematic review on training outcomes influencing physical fitness , activity of daily living performance , and quality -of-life in institutionalized older people .
Our ultimate goal was to propose criteria for an evidence -based exercise protocol aim ed at improving physical fitness , activity of daily living performance , and quality -of-life of frail institutionalized older people . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,424 | 19,328,797 | Anxiety is associated with uninvestigated and functional dyspepsia (Rome III criteria) in a Swedish population-based study. | BACKGROUND & AIMS The Rome III criteria for functional dyspepsia have been changed to include 2 distinct syndromes : postpr and ial distress syndrome and epigastric pain syndrome . We investigated risk factors for functional dyspepsia among the functional dyspepsia subgroups defined by the Rome III criteria . METHODS We performed a cross-sectional population -based study in a primary care setting ( the Kalix and a study ) . A r and om sample ( n = 2860 ) of the adult population from 2 northern Swedish municipalities ( n = 21,610 ) was surveyed using a vali date d postal question naire to assess gastrointestinal symptoms ( response rate , 74.2 % ; n = 2122 ) . A r and omly selected subgroup ( n = 1001 ) of responders was invited to undergo an esophagogastroduodenoscopy ( participation rate , 73.3 % ) including biopsy specimen collection , Helicobacter pylori culture and serology , and symptom assessment s. RESULTS Of the 1001 subjects examined by endoscopy , 202 ( 20.2 % ; 95 % confidence interval [ CI ] , 17.7 - 22.7 ) were classified as having uninvestigated dyspepsia and 157 ( 15.7 % ; 95 % CI , 13.4 - 18.0 ) as having functional dyspepsia . Major anxiety ( Hospital Anxiety and Depression Scale score > or = 11 ) was associated with uninvestigated dyspepsia ( odds ratio [ OR ] , 3.01 ; 95 % CI , 1.39 - 6.54 ) , as was obesity ( body mass index > or = 30 kg/m(2 ) ) ( OR , 1.86 ; 95 % CI , 1.15 - 3.01 ) . Major anxiety was associated with functional dyspepsia and postpr and ial distress syndrome ( OR of 2.56 [ 95 % CI , 1.06 - 6.19 ] and 4.35 [ 95 % CI , 1.81 - 10.46 ] , respectively ) , as was use of nonsteroidal anti-inflammatory drugs ( OR , 2.49 [ 95 % CI , 1.29 - 4.78 ] and 2.75 [ 95 % CI , 1.38 - 5.50 ] , respectively ) . Depression was not associated with any dyspepsia group . CONCLUSIONS Anxiety but not depression is linked to uninvestigated dyspepsia , functional dyspepsia , and postpr and ial distress syndrome but not to epigastric pain syndrome | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,425 | 23,171,089 | Visceral and somatic sensory function in functional dyspepsia. | BACKGROUND Visceral hypersensitivity is one of the proposed underlying mechanisms in functional dyspepsia ( FD ) . It is not clear whether visceral hypersensitivity in FD is a manifestation of a central sensitization also encompassing somatic sensitization . Transient receptor potential vanilloid-1 ( TRPV(1 ) ) pathways are involved in gastric mechanosensory physiology and the TRPV(1 ) receptor agonist , capsaicin , has been used as a chemical stimulant . METHODS In this double-blind , r and omized study we evaluated both visceral and somatic sensory function in 34 FD patients and 42 healthy controls using quantitative sensory testing . Visceral pain sensitivity was assessed using a vali date d gastric pain model with oral capsaicin capsule titration and somatic pain sensitivity was determined by foot heat and h and electric stimulation . KEY RESULTS The median capsaicin dose required to attain moderate pain was 0.5 mg in FD and 1 mg in controls ( P = 0.03 ) . At these doses , mean pain intensities on a 0 - 100 visual analog scale were greater for FD than controls [ 56.9 ( 95 % confidence intervals , 52.2 - 61.5 ) vs 45.1 ( 41.6 - 48.6 ) , resp . ] ( P = 0.005 ) . Overall , mean somatic sensory and pain thresholds were similar in FD and control groups , but in a subgroup of FD pain hypersensitivity was seen on the h and and on the foot at different stimulation thresholds . CONCLUSIONS & INFERENCES A majority of patients with FD have visceral chemo-hypersensitivity involving TRPV(1 ) pathways . A substantial subgroup also has somatic hypersensitivity as evidence of central sensitization | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,426 | 17,686,660 | Non-ulcer dyspepsia and duodenal eosinophilia: an adult endoscopic population-based case-control study. | BACKGROUND & AIMS Functional abnormalities of the duodenum have been observed in non-ulcer dyspepsia . We aim ed to identify whether eosinophils in the upper gastrointestinal tract are a biomarker for non-ulcer dyspepsia . METHODS A r and om sample of an adult Swedish population ( n = 1001 ; mean age , 54 y ; 51 % female ) underwent upper endoscopy . Non-ulcer dyspepsia cases ( n = 51 , Rome II ) and r and omly selected controls ( n = 48 ) were identified . Two blinded independent observers assessed the gastroduodenal eosinophil counts . Eosinophils were quantified by counting the number per 5 high-power fields at each of 5 sites ( cardia , body , antrum , D1 duodenal bulb , and D2 second portion of duodenum ) , and total counts were summed over the 5 fields at each site . RESULTS The odds ratio for non-ulcer dyspepsia ( vs asymptomatic controls ) in subjects with high duodenal bulb eosinophil counts ( median , > /=22 , relative to < 22 ) was 11.7 ( 95 % confidence interval , 3.9 - 34.9 ) , adjusting for age , sex , and H pylori ; similar results were observed in D2 ( odds ratio = 7.3 ; 95 % confidence interval , 2.9 - 18.1 ) . A significant association with the number of eosinophil clusters was detected in the duodenum , with higher values in non-ulcer dyspepsia ( P < .01 ) . By immunostaining with major basic protein antibody in a subset of duodenal biopsy specimens , eosinophil degranulation was observed in non-ulcer dyspepsia ( 7 of 15 vs 0 of 5 controls ; P = .11 ) . Gastric eosinophil counts were overall not significantly increased in non-ulcer dyspepsia vs controls . Early satiety was associated with eosinophilia in D1 ( P = .01 ) and D2 ( P = .02 ) , adjusting for age , sex , and H pylori . CONCLUSIONS Duodenal eosinophilia may characterize a subset of adults with non-ulcer dyspepsia | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,427 | 23,155,342 | Treatment of functional dyspepsia with sertraline: a double-blind randomized placebo-controlled pilot study. | AIM To evaluate sertraline , a selective serotonin reuptake inhibitor in the treatment of patients with functional dyspepsia . METHODS Consecutive tertiary hospital patients with a clinical diagnosis of functional dyspepsia ( FD ) according to the Rome II criteria with a Hong Kong dyspepsia index ( HKDI ) of greater than 16 were recruited . Patients commenced enrolment prior to the inception of the Rome III criteria for functional dyspepsia . All patients were ethnic Chinese , had a normal upper endoscopy and were Helicobacter pylori negative prior to enrolment . Study patients were r and omized to receive sertraline 50 mg or placebo daily for 8 wk . HKDI symptom scores , quality of life , hospital anxiety and depression ( HAD ) scale and global symptom relief were evaluated before , during and after treatment . Adverse effects were monitored during and after treatment . RESULTS A total of 193 patients were r and omized in the intention to treat ( ITT ) , and 150 patients were included in the per protocol ( PP ) analysis . In both the ITT and PP , there was no difference in the primary outcome of global dyspepsia symptoms between the sertraline and placebo groups at week 8 . In the ITT analysis , 98 and 95 patients were r and omized to the sertraline and placebo groups respectively . A total of 43 patients withdrew from the study ( 22.3 % ) by week 8 , with 23 of the 24 drop-outs in the sertraline group occurring prior to week 4 ( 95.8 % ) . In contrast , in the placebo arm , 11 of 19 patients dropped out by week 4 ( 57.9 % ) . Utilizing the last response carried forward to account for the drop-outs , there were no differences between the sertraline and placebo groups at baseline in terms of the HKDI , HKDI 26.08 ± 6.19 vs 26.70 ± 5.89 , P = 0.433 ; and at week 8 , HKDI 22.41 ± 6.36 vs 23.25 ± 7.30 , P = 0.352 respectively . In the PP analysis , 74 and 76 patients were r and omized to the sertraline and placebo groups respectively . At baseline , there were no statistically significant differences between the sertraline and placebo groups , HKDI 25.83 ± 6.313 vs 27.19 ± 5.929 respectively , P = 0.233 ; however by week 8 , patients in the sertraline group demonstrated a statistically significant difference in their Hong Kong Dyspepsia Index compared to placebo , HKDI 20.53 ± 6.917 vs 23.34 ± 7.199 , P = 0.02 , respectively ) . There was also no statistically significant difference in overall quality of life measures or the HAD scale related to treatment in either the ITT or PP analysis at week 8 . CONCLUSION This pilot study , the first to examine sertraline , a selective serotonin reuptake inhibitor , for the management of FD , did not find that it was superior to placebo | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,428 | 18,803,000 | Effects of Amitriptyline on Gastric Sensorimotor Function and Postprandial Symptoms in Healthy Individuals: A Randomized, Double-Blind, Placebo-Controlled Trial | BACKGROUND : Low-dose tricyclic antidepressants have been used to treat chronic somatic and gastrointestinal pain disorders , including refractory functional dyspepsia . However , there are only limited data on the effects of these drugs on upper gastrointestinal function . AIM : To compare the effects of two doses of amitriptyline ( AMT ) and placebo on gastric accommodation , emptying , satiation , and postpr and ial symptoms in healthy volunteers . METHODS : Using a parallel-group , double-blind , placebo-controlled design , 41 healthy volunteers were r and omized to AMT 25 mg , AMT 50 mg , or placebo for 2 wk . During the final 3 days of therapy , the following end points were assessed : fasting and postpr and ial gastric volumes , 2- and 4-h gastric emptying , time and volume to maximum satiation using a nutrient drink test , and postpr and ial symptoms 30 min later using 10-cm visual analog scales . AMT and metabolite levels were measured . RESULTS : AMT slowed gastric emptying at 2 h ( median 75 % for placebo , 57 % for AMT 25 mg , 67 % for AMT 50 mg ; P= 0.037 ) and 4 h ( median 98 % for placebo , 96 % for AMT 25 mg , 92 % for AMT 50 mg ; P= 0.003 ) . AMT did not affect gastric volumes or satiation volume , but it did reduce nausea scores at 30 min in a dose-dependent manner ( median 2.1 for placebo , 0.9 for AMT 25 mg , and 0.0 for AMT 50 mg ; P= 0.009 ) . CONCLUSION : In healthy volunteers , AMT slows gastric emptying of solids , but it does not significantly affect gastric volumes or satiation . AMT reduces nausea after challenge with a high calorie liquid load | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,429 | 19,220,756 | A placebo-controlled trial of the 5-HT1A agonist R-137696 on symptoms, visceral hypersensitivity and on impaired accommodation in functional dyspepsia. | Acute studies suggested a therapeutic benefit for fundus-relaxing drugs in functional dyspepsia ( FD ) with visceral hypersensitivity ( VH ) to gastric distention or impaired accommodation ( IA ) , but long-term studies are lacking . R-137696 is a serotonin-1A ( 5-HT(1A ) ) receptor agonist which relaxes the proximal stomach in man . Our aim was to investigate the influence of R-137696 on symptoms in FD with VH or IA . R and omized , double-blind , placebo-controlled , parallel group study of 4 weeks R-137696 2 mg t.i.d . in FD with VH or IA . Symptoms were assessed using the patient assessment of upper gastrointestinal symptom severity index ( PAGI-SYM ) total score and individual symptom subscales . Barostat studies were performed before and after 4 weeks of treatment . Fifty-three patients ( 33 VH and 20 IA ) , 18 men , mean age 40 + /- 13 years were recruited . Twenty-four received placebo and 29 received R-137696 . In VH patients , both placebo and R-137696 improved total symptom scores , with a tendency for superiority of placebo ( -1.12 vs-0.51 , P = 0.07 ) . Placebo was superior for the subscales of early satiety , bloating , fullness and discomfort ( all P < 0.05 ) . In IA , both placebo and R-137696 had no significant influence on total or individual symptom scores ( -0.08 and -0.27 ) . In VH , both placebo and R-137696 increased the discomfort volume , without a statistical difference between both arms ( + 120 and + 164 mL ) . In IA , both placebo and R-137696 enhanced accommodation , without a statistical difference between both ( + 77 and + 159 mL ) . Adverse events were similar for drug and placebo . A 4-week administration of the fundus-relaxing 5-HT(1A ) agonist R-137696 failed to significantly improve symptoms , VH or gastric accommodation compared to placebo | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,430 | 23,147,521 | Clinical Guideline: Management of Gastroparesis | This guideline presents recommendations for the evaluation and management of patients with gastroparesis . Gastroparesis is identified in clinical practice through the recognition of the clinical symptoms and documentation of delayed gastric emptying . Symptoms from gastroparesis include nausea , vomiting , early satiety , postpr and ial fullness , bloating , and upper abdominal pain . Management of gastroparesis should include assessment and correction of nutritional state , relief of symptoms , improvement of gastric emptying and , in diabetics , glycemic control . Patient nutritional state should be managed by oral dietary modifications . If oral intake is not adequate , then enteral nutrition via jejunostomy tube needs to be considered . Parenteral nutrition is rarely required when hydration and nutritional state can not be maintained . Medical treatment entails use of prokinetic and antiemetic therapies . Current approved treatment options , including metoclopramide and gastric electrical stimulation ( GES , approved on a humanitarian device exemption ) , do not adequately address clinical need . Antiemetics have not been specifically tested in gastroparesis , but they may relieve nausea and vomiting . Other medications aim ed at symptom relief include unapproved medications or off-label indications , and include domperidone , erythromycin ( primarily over a short term ) , and central ly acting antidepressants used as symptom modulators . GES may relieve symptoms , including weekly vomiting frequency , and the need for nutritional supplementation , based on open-label studies . Second-line approaches include venting gastrostomy or feeding jejunostomy ; intrapyloric botulinum toxin injection was not effective in r and omized controlled trials . Most of these treatments are based on open-label treatment trials and small numbers . Partial gastrectomy and pyloroplasty should be used rarely , only in carefully selected patients . Attention should be given to the development of new effective therapies for symptomatic control | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,431 | 15,951,533 | Dyspeptic patients with visceral hypersensitivity: sensitisation of pain specific or multimodal pathways? | Background and aims : Patients with functional dyspepsia who have hypersensitivity to gastric distension have more prevalent pain , suggesting the presence of hyperalgesia . It is unclear whether this reflects activation of pain specific afferent pathways or multimodal afferent pathways that also mediate non-painful sensations . In the former case , hyperalgesia should occur when intensity of non-painful sensations is still low . The aim of the study was to analyse whether the symptom profile during gastric dissentions in functional dyspepsia patients with hyperalgesia reflects sensitisation of pain specific or multimodal pathways . Methods : Forty eight consecutive dyspeptic patients ( 35 female ) underwent gastric sensitivity testing with a barostat balloon using a double r and om staircase protocol . At the end of every distending step , patients scored perception of upper abdominal sensations on a graphic 0–6 rating scale and completed visual analogue scales ( VAS 0–100 mm ) for pain , nausea , satiety , and fullness . The end point was a rating scale of 5 or more . Results : Hypersensitivity was present in 20 patients ( 40 % ) ; gastric compliance did not differ between normo- and hypersensitive patients . At maximal distension ( score 5 or more ) , hypersensitive patients had significantly lower distending pressures and intra-balloon volumes , but similar VAS scores for pain , nausea , satiety , and fullness compared with normosensitive patients . In both normosensitive and hypersensitive patients , elevation of pain VAS scores with increasing distending pressures paralleled the elevation in VAS scores for nausea , satiety , and fullness . Conclusions : Hypersensitive dyspeptic patients reach the same intensity of painful and non-painful sensations as normosensitive patients but at lower distending pressures . Hyperalgesia occurs in hypersensitive dyspeptic patients at distending pressures that also induce intense non-painful sensations . These findings argue against isolated upregulation of pain specific afferents in functional dyspepsia patients with visceral hypersensitivity | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,432 | 4,531,935 | Effects of Levosulpiride in Patients with Functional Dyspepsia Accompanied by Delayed Gastric Emptying | Objectives Levosulpiride is the levo-enantiomer of sulpiride , a well-known antiemetic , antidyspeptic and antipsychotic drug . This study was undertaken to investigate the effects of levosulpiride on dyspeptic symptoms and gastric motor function in a group of patients with functional dyspepsia showing delayed gastric emptying . Method Forty two eligible patients were entered into a 3 week , double-blind r and omized comparison of 25 mg of levosulpiride or placebo t.i.d .. Symptom assessment and gastric scintigraphy following the intake of scrambled egg s and wich , were performed in each patient before and after treatment . Results The improvement of symptom score in levosulpiride group was higher than the placebo group ( p<0.05 ) . We assessed global efficacy , which was excellent in 1 ( 6 % ) , good 11 ( 65 % ) , fair 4 ( 24 % ) , nil 1 ( 6 % ) of those receiving levosulpiride , and fair 9(60 % ) , nil 5 ( 33 % ) , poor 1 ( 6 % ) of those receiving placebo . Levosulpiride tended to be more effective than placebo in relieving the dyspeptic symptoms especially in the subgroups of dysmotility-like ( p<0.05 ) and nonspecific ( p<0.05 ) as compared to other subgroups ( p=0.16 ) . The reduction of gastric emptying time after levosulpiride treatment was more marked than Placebo group ( p<0.05 ) . We found a significant correlation between changes of symptom score and gastric emptying time ( r=0.47 , p=0.01 . No serious adverse effects were reported after administration of either levosulpiride or placebo . Only two patients reported mild somnolence during levosulpiride administration . Conclusions Levosulpiride is effective and well tolerated in patients with functional dyspepsia accompanied by delayed gastric emptying . Its efficacy may be related to its action on the gastric motor function by improving the delayed gastric emptying | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,433 | 19,638,966 | Efficacy of the 5-HT1A Agonist Tandospirone Citrate in Improving Symptoms of Patients With Functional Dyspepsia: A Randomized Controlled Trial | OBJECTIVES : Functional dyspepsia ( FD ) is a common condition in the general population ; however , its treatment remains a challenge . The aim of this study was to examine the efficacy of t and ospirone citrate , a new partial agonist of the 5-hydroxytryptamine 1A ( 5-HT1A ) receptor , in improving the symptoms of patients with FD . METHODS : In this double-blind , placebo-controlled , multicenter study , FD patients were r and omized to treatment with 10 mg t.i.d . t and ospirone citrate or to placebo for 4 weeks . The primary end point was change in abdominal symptom scores . The difference in the proportion of responders ( a total abdominal symptom score of 0 or 1 ) was also assessed . The quality -of-life question naire , the SF-8 , and a psychological test question naire , the State-Trait Anxiety Inventory ( STAI ) , were completed at baseline and at weekly intervals . RESULTS : Data were available for 144 patients : 73 for t and ospirone and 71 for placebo . Improvements in total abdominal scores were significantly larger with t and ospirone than placebo at weeks 1 , 2 , and 4 . Significantly greater improvements in the t and ospirone group were observed in upper abdominal pain ( P=0.02 ) and discomfort ( P=0.002 ) at week 4 . The proportion of responders was significantly greater in the active treatment arm at weeks 3 ( P=0.017 ) and 4 ( P=0.0016 ) . Significant improvements in STAI ( P<0.0001 ) were reported in both arms , as well as in the majority of questions in the SF-8 ( P=0.04 ) . No serious adverse events were reported , with similar rates in both study arms . CONCLUSIONS : Despite a considerable placebo effect , the benefits of t and ospirone were shown in terms of improvement in abdominal symptom scores | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,434 | 17,678,917 | Natural history of functional gastrointestinal disorders: a 12-year longitudinal population-based study. | BACKGROUND & AIMS Functional gastrointestinal disorders ( FGID ) are common in the community . The natural history of FGID is unknown because of a lack of prospect i ve population -based studies and the indistinct nature of the phenotype . We sought to report the natural history of FGID in a US population . METHODS This prospect i ve cohort study used data from multiple vali date d surveys of r and om sample s of Olmsted County , MN , residents over a mean of a 12-year period between 1988 and 2003 ( n = 1365 ) . The surveys measured gastrointestinal symptoms experienced during the past year . Each subject received a minimum of 2 surveys . Point prevalence , onset , and disappearance rates and transition probabilities were calculated for individual FGIDs . RESULTS Between the initial and final surveys , the point prevalences ( per 100 residents ) were stable for irritable bowel syndrome ( 8.3 % and 11.4 % , respectively ) and functional dyspepsia ( 1.9 % and 3.3 % , respectively ) . The onset of each of the disorders studied was greater than the disappearance rate , but the transition probabilities varied across the different subgroups . Among people with symptoms at baseline , approximately 20 % had the same symptoms , 40 % had no symptoms , and 40 % had different symptoms at follow-up . CONCLUSIONS Although the prevalence of the FGID was stable over time , the turnover in symptom status was high . Many episodes of symptom disappearance were due to subjects changing symptoms rather than total symptom resolution . This transition between different FGIDs suggests a common etiopathogenesis | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,435 | 7,734,028 | The eflects of levosulpiride on gastric and gall‐bladder emptying in functional dyspepsia | Background : 50 % of patients with functional dyspepsia have delayed gastric emptying . Levosulpiride is an orthopramide drug that stimulates gastrointestinal motility . Aim of our study was to evaluate the effect of levosulpiride on symptoms and gastric and gall‐bladder emptying , in dyspeptic patients | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,436 | 18,424,191 | Effect of the antidepressant venlafaxine in functional dyspepsia: a randomized, double-blind, placebo-controlled trial. | BACKGROUND & AIMS Antidepressants could be effective in the treatment of functional gastrointestinal disorders through their anticholinergic and pain-modulating effects . Previous studies with these drugs lacked sufficient power and were predominantly conducted in patients with irritable bowel syndrome . This study aim ed to assess the effectiveness of the serotonin and norepinephrine reuptake inhibitor venlafaxine in patients with functional dyspepsia . METHODS This was a multi-center , r and omized , double-blind , placebo-controlled trial . Participants had persistent dyspeptic symptoms and underwent upper gastrointestinal endoscopy in a secondary care hospital to exclude organic abnormalities . They were r and omly assigned to receive 8 weeks of treatment with either venlafaxine XR ( 2 weeks 75 mg once daily , 4 weeks 150 mg once daily , and 2 weeks 75 mg once daily ) or placebo . Symptoms , health-related quality of life , anxiety , and depression were assessed before and at 4 , 8 , 12 , and 20 weeks after inclusion . RESULTS One hundred sixty patients were r and omized ; 56 % and 73 % of participants completed treatment with venlafaxine or placebo , respectively , according to protocol . There was no difference in proportions of symptom-free patients after 8 weeks of treatment or at 20 weeks after inclusion , with venlafaxine in comparison to placebo ( 37 % and 39 % , respectively ; odds ratio [ OR ] , 0.8 ; 95 % confidence interval [ CI ] , 0.3 - 2.1 ; and 42 % and 41 % , respectively ; OR , 3.1 ; 95 % CI , 0.9 - 12.6 ) . Per- protocol analysis did not reveal any differences between venlafaxine and placebo either ( 38 % and 39 % symptom-free , respectively ; OR , 1.0 ; 95 % CI , 0.4 - 2.4 at 8 weeks ) . CONCLUSIONS Treatment with the selective serotonin and norepinephrine reuptake inhibitor venlafaxine is not more effective than placebo in patients with functional dyspepsia | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,437 | 12,622,770 | Influence of the selective serotonin re‐uptake inhibitor, paroxetine, on gastric sensorimotor function in humans | Background : The role of 5‐hydroxytryptamine in the control of gastric fundus tone in humans is still unknown . Selective 5‐hydroxytryptamine re‐uptake inhibitors act both central ly and peripherally to enhance the availability of physiologically released 5‐hydroxytryptamine | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,438 | 17,965,059 | Itopride in functional dyspepsia: results of two phase III multicentre, randomised, double-blind, placebo-controlled trials | Background : Functional dyspepsia ( FD ) is a common disorder but there is currently little efficacious drug therapy . Itopride , a prokinetic approved in several countries , showed promising efficacy in FD in a phase IIb trial . The aim of this study was to test the efficacy and safety of this drug in FD . Methods : Two similar placebo-controlled clinical trials were conducted ( International and North America ) . Males and females , 18–65 years old , with a diagnosis of FD ( Rome II ) and the absence ( by upper endoscopy ) of any relevant structural disease were recruited . All were negative for Helicobacter pylori and , if present , heartburn could not exceed one episode per week . Following screening , patients were r and omised to itopride 100 mg three times daily or identical placebo . The co- primary end points were : ( 1 ) global patient assessment ( GPA ) of efficacy ; and ( 2 ) Leeds Dyspepsia Question naire ( LDQ ) . Symptoms were evaluated at weeks 2 , 4 and 8 . Secondary measures of efficacy included Nepean Dyspepsia Index ( NDI ) quality of life . Results : The GPA responder rates at week 8 on itopride versus placebo were similar in both trials ( 45.2 % vs 45.6 % and 37.8 vs 35.4 % , respectively ; p = NS ) . A significant benefit of itopride over placebo was observed for the LDQ responders in the International ( 62 % vs 52.7 % , p = 0.04 ) but not the North American trial ( 46.9 % vs 44.8 % ) . The safety and tolerability profile were comparable with placebo , with the exception of prolactin elevations , which occurred more frequently on itopride ( 18/579 ) than placebo ( 1/591 ) . Conclusion : In this population with FD , itopride did not show a difference in symptom response from placebo | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,439 | 8,726,297 | A new pharmacologic treatment of functional gastrointestinal disorder. A double-blind placebo-controlled study with mianserin. | BACKGROUND The efficacy of unselected monoamine reuptake inhibitors ( tricyclic antidepressants ) in the treatment of patients with functional gastrointestinal disorders ( FGD ) has not been convincingly demonstrated . We investigated the efficacy of an antidepressant ( mianserin ) with a different receptor profile ( combined 5-hydroxytryptamine-2 + 3 and alpha-2 antagonist ) in FGD . METHODS After excluding patients with psychopathology and initial placebo responders from the study , eligible patients ( n = 49 ) were r and omized to 7 weeks of double-blind treatment with either mianserin , 120 mg/day , or placebo . Efficacy was assessed by using observer-completed ratings , the Global Improvement Scale , and patient self-ratings , Visual Analog Scale , and Disability Scales . RESULTS Patients taking mianserin reported less abdominal pain , symptoms of abdominal distress , and functional disability than those given placebo ( p < 0.001 ) . The efficacy was significant across different lengths of illness periods and types of functional disorder . There was no major change 4 weeks after tapering . CONCLUSION Mianserin may be an effective and well-tolerated pharmacologic short-term treatment for functional gastrointestinal disorders in patients with no clinical evidence of psychopathology | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,440 | 22,813,445 | Efficacy of buspirone, a fundus-relaxing drug, in patients with functional dyspepsia. | BACKGROUND & AIMS Impaired accommodation and hypersensitivity to gastric distention are believed to be involved in the development of functional dyspepsia ( FD ) . Buspirone , a 5-hydroxytryptamine 1A receptor agonist , relaxes the proximal stomach in healthy individuals . We studied the effects of buspirone on symptoms and mechanisms of FD . METHODS We performed a r and omized , double-blind , placebo-controlled , crossover study of 17 patients ( 13 women ; mean age , 38.5 ± 2.4 years ) . The study included 2 treatment periods of 4 weeks each , separated by a 2-week washout period . In the first period , 7 participants were given buspirone ( 10 mg , 3 times daily for 4 weeks ) and 10 were given placebo 15 minutes before meals ; patients switched groups for the second period . We assessed meal-related symptoms and severity , along with gastric sensitivity , accommodation , and emptying ( by using barostat and breath tests ) before and after 4 weeks of treatment . RESULTS Buspirone significantly reduced the overall severity of symptoms of dyspepsia ( 7.5 ± 1.3 vs 11.5 ± 1.2 for placebo ; P < .005 ) and individual symptoms of postpr and ial fullness , early satiation , and upper abdominal bloating , whereas placebo had no significant effect ( all P < .05 ) . Buspirone did not alter the rate of gastric emptying of solids or sensitivity to gastric distention , but it significantly increased gastric accommodation , compared with placebo ( 229 ± 28 vs 141 ± 32 mL , respectively ; P < .05 ) , and delayed gastric emptying of liquids ( half-life = 64 ± 5 vs 119 ± 24 minutes , respectively ) . Adverse events were similar when patients were given buspirone or placebo . CONCLUSIONS In patients with FD , 4 weeks of administration of buspirone significantly improved symptoms and gastric accommodation , compared with placebo , whereas gastric emptying of liquids was delayed | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,441 | 10,792,119 | Comparative effects of levosulpiride and cisapride on gastric emptying and symptoms in patients with functional dyspepsia and gastroparesis | The efficacy of several prokinetic drugs on dyspeptic symptoms and on gastric emptying rates are well‐established in patients with functional dyspepsia , but formal studies comparing different prokinetic drugs are lacking | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,442 | 25,621,434 | Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. | IMPORTANCE Many medications have anticholinergic effects . In general , anticholinergic-induced cognitive impairment is considered reversible on discontinuation of anticholinergic therapy . However , a few studies suggest that anticholinergics may be associated with an increased risk for dementia . OBJECTIVE To examine whether cumulative anticholinergic use is associated with a higher risk for incident dementia . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve population -based cohort study using data from the Adult Changes in Thought study in Group Health , an integrated health care delivery system in Seattle , Washington . We included 3434 participants 65 years or older with no dementia at study entry . Initial recruitment occurred from 1994 through 1996 and from 2000 through 2003 . Beginning in 2004 , continuous replacement for deaths occurred . All participants were followed up every 2 years . Data through September 30 , 2012 , were included in these analyses . EXPOSURES Computerized pharmacy dispensing data were used to ascertain cumulative anticholinergic exposure , which was defined as the total st and ardized daily doses ( TSDDs ) dispensed in the past 10 years . The most recent 12 months of use was excluded to avoid use related to prodromal symptoms . Cumulative exposure was up date d as participants were followed up over time . MAIN OUTCOMES AND MEASURES Incident dementia and Alzheimer disease using st and ard diagnostic criteria . Statistical analysis used Cox proportional hazards regression models adjusted for demographic characteristics , health behaviors , and health status , including comorbidities . RESULTS The most common anticholinergic classes used were tricyclic antidepressants , first-generation antihistamines , and bladder antimuscarinics . During a mean follow-up of 7.3 years , 797 participants ( 23.2 % ) developed dementia ( 637 of these [ 79.9 % ] developed Alzheimer disease ) . A 10-year cumulative dose-response relationship was observed for dementia and Alzheimer disease ( test for trend , P < .001 ) . For dementia , adjusted hazard ratios for cumulative anticholinergic use compared with nonuse were 0.92 ( 95 % CI , 0.74 - 1.16 ) for TSDDs of 1 to 90 ; 1.19 ( 95 % CI , 0.94 - 1.51 ) for TSDDs of 91 to 365 ; 1.23 ( 95 % CI , 0.94 - 1.62 ) for TSDDs of 366 to 1095 ; and 1.54 ( 95 % CI , 1.21 - 1.96 ) for TSDDs greater than 1095 . A similar pattern of results was noted for Alzheimer disease . Results were robust in secondary , sensitivity , and post hoc analyses . CONCLUSIONS AND RELEVANCE Higher cumulative anticholinergic use is associated with an increased risk for dementia . Efforts to increase awareness among health care professionals and older adults about this potential medication-related risk are important to minimize anticholinergic use over time | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,443 | 21,118,281 | The effects of acute citalopram dosing on gastric motor function and nutrient tolerance in healthy volunteers | Aliment Pharmacol Ther 2011 ; 33 : 395–402 | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,001 | 26,567,029 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . | 48,444 | 25,921,377 | Effect of Amitriptyline and Escitalopram on Functional Dyspepsia: A Multicenter, Randomized Controlled Study. | BACKGROUND & AIMS Antidepressants are frequently prescribed to treat functional dyspepsia ( FD ) , a common disorder characterized by upper abdominal symptoms , including discomfort or postpr and ial fullness . However , there is little evidence of the efficacy of these drugs in patients with FD . We performed a r and omized , double-blind , placebo-controlled trial to evaluate the effects of antidepressant therapy on symptoms , gastric emptying ( GE ) , and meal-induced satiety in patients with FD . METHODS We performed a study at 8 North American sites of patients who met the Rome II criteria for FD and did not have depression or use antidepressants . Patients ( n = 292 ; 44 ± 15 years old , 75 % were female , 70 % with dysmotility-like FD , and 30 % with ulcer-like FD ) were r and omly assigned to groups given placebo , 50 mg amitriptyline , or 10 mg escitalopram for 10 weeks . The primary end point was adequate relief of FD symptoms for ≥5 weeks of the last 10 weeks ( of 12 ) . Secondary end points included GE time , maximum tolerated volume in Nutrient Drink Test , and FD-related quality of life . RESULTS An adequate relief response was reported by 39 subjects given placebo ( 40 % ) , 51 given amitriptyline ( 53 % ) , and 37 given escitalopram ( 38 % ) ( P = .05 , after treatment , adjusted for baseline balancing factors including all subjects ) . Subjects with ulcer-like FD given amitriptyline were > 3-fold more likely to report adequate relief than those given placebo ( odds ratio = 3.1 ; 95 % confidence interval : 1.1 - 9.0 ) . Neither amitriptyline nor escitalopram appeared to affect GE or meal-induced satiety after the 10-week period in any group . Subjects with delayed GE were less likely to report adequate relief than subjects with normal GE ( odds ratio = 0.4 ; 95 % confidence interval : 0.2 - 0.8 ) . Both antidepressants improved overall quality of life . CONCLUSIONS Amitriptyline , but not escitalopram , appears to benefit some patients with FD , particularly those with ulcer-like ( painful ) FD . Patients with delayed GE do not respond to these drugs . Clinical Trials.gov ID : NCT00248651 | 2,001 | However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made . | Objective Functional dyspepsia ( FD ) is a chronic gastroduodenal disorder .
Individuals with FD demonstrate visceral hypersensitivity , abnormal central pain processing , and low mood , but it is unclear whether psychotropic drugs are an effective treatment for the condition . |
2,002 | 28,472,417 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . | 48,445 | 16,885,388 | Cognitive and motor development of 8-year-old children born after ICSI compared to spontaneously conceived children. | BACKGROUND As a continuation of two large-scale , multicentre studies on the development of 5-year-old ICSI children , we present results of the follow-up study undertaken on the cognitive and motor development of 8-year-old ICSI children . METHODS Developmental outcomes of 151 8-year-old singletons born through ICSI after 32 weeks of gestation were compared with those of 153 singletons of the same age born after spontaneous conception ( SC ) . Part of this population was seen in a cohort at the age 5 years . Outcome measures include Wechsler Intelligence Scale for Children-Revised ( WISC-R ) and Movement Assessment Battery for Children ( ABC ) . RESULTS Regarding intellectual functioning , ICSI children tend to obtain significantly higher total ( P < 0.01 ) , verbal ( P < 0.01 ) and performance ( P < 0.05 ) intelligence scores than SC children , nevertheless remaining in similar ranges . These effects are small ( Cohen 's d < 0.50 ) . High maternal educational level stayed in the regression as a factor accounting for some of the variance in total IQ between the groups . In terms of motor development , no significant differences were found between ICSI and SC children regarding overall motor skills , manual , balance and ball skills . CONCLUSION In this follow-up study , ICSI and SC children show a comparable cognitive and motor development until the age of 8 years | 2,002 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . |
2,002 | 28,472,417 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . | 48,446 | 26,516,205 | Mental health and developmental outcomes for children born after ART: a comparative prospective study on child gender and treatment type. | STUDY QUESTION Do children born after assisted reproductive techniques ( ART ; IVF/ICSI ) display more mental health issues or social and cognitive developmental problems at 7 - 8 years than naturally conceived ( NC ) controls , and does child gender play a role ? SUMMARY ANSWER ART children do not differ with regard to mental health or social and cognitive developmental problems when compared with controls , but some gender-specific differences do exist . WHAT IS KNOWN ALREADY Systematic review s have not found any evidence of delays in neurocognitive or sensorimotor development in ART children . However findings on the effect of the type of ART treatment ( IVF versus ICSI ) on the offspring 's physical and mental development have not been uniform . Knowledge of the role of child gender in ART research is scarce . STUDY DESIGN , SIZE , DURATION This prospect i ve follow-up study compares mental health and social and cognitive developmental problems between 7 - 8-year-old ART and NC children , controlling for the father 's age , length of the parents ' partnership , mother 's parity , child 's gestational age , and the need of neonatal intensive care unit ( NICU ) . Further , within the ART group , we analysed whether the treatment type ( IVF versus ICSI ) and the child 's gender are associated with the mental health and developmental outcomes . PARTICIPANTS / MATERIAL S , SETTING , METHODS In this study , 255 singleton ART children ( IVF and ICSI ) were compared with 278 NC children on parent-reported internalizing and externalizing symptoms , and social ( social skills and peer relations ) and cognitive development ( executive functioning , perception , memory , and language ) . Within the ART group , 164 IVF and 76 ICSI children were compared on the same outcomes . Statistics included analyses of covariates ( ANCOVA ) with group main effects , group and gender interaction effects , and Bonferroni post hoc tests . MAIN RESULTS AND THE ROLE OF CHANCE ART and NC children did not differ generally in terms of their internalizing and externalizing symptoms or in the number of social and cognitive developmental problems ( Group main effects , P > 0.05 ) , but gender-specific group differences existed . The ART boys showed lower levels of cognitive problems than the NC boys , whereas ART girls showed higher levels of cognitive problems than the NC girls ( Group × Gender-interaction effects with Bonferroni post hoc tests on mother-reports , P < 0.01 ) . Further , unlike in the NC group , where boys showed more externalizing symptoms and social and cognitive developmental problems than girls ( Group × Gender-interaction effects with Bonferroni post hoc tests for both parents ' reports , P < 0.05 ) , gender differences were not found in the ART group . Within the ART group , IVF and ICSI children did not differ in terms of mental health or developmental outcomes , and no significant gender differences emerged . LIMITATIONS , REASONS FOR CAUTION The information on children 's mental health and development was based on parental reports only . The dropout rate between the child 's first year and the school age assessment s was very high for fathers ( 57.4 % ) and substantial for mothers ( 30.1 % ) , and the participating group was biased for older age of both parents and for better education of the fathers . WIDER IMPLICATION S OF THE FINDINGS The findings indicate the importance of considering child gender in learning about multiple developmental outcomes among children born after ART . STUDY FUNDING /COMPETING INTERESTS This study was supported by the Academy of Finl and ( # 11232276 ) , the Emil Aaltonen Foundation , The Family Federation of Finl and , Helsinki University Central Hospital Research Funds , and the National Graduate School of Psychology . None of authors has any competing interests to declare | 2,002 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . |
2,002 | 28,472,417 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . | 48,447 | 20,530,080 | US National Longitudinal Lesbian Family Study: Psychological Adjustment of 17-Year-Old Adolescents | OBJECTIVES : The objective of this study was to document the psychological adjustment of adolescents who were conceived through donor insemination by lesbian mothers who enrolled before these offspring were born in the largest , longest running , prospect i ve , longitudinal study of same-sex – parented families . METHODS : Between 1986 and 1992 , 154 prospect i ve lesbian mothers volunteered for a study that was design ed to follow planned lesbian families from the index children 's conception until they reached adulthood . Data for the current report were gathered through interviews and question naires that were completed by 78 index offspring when they were 10 and 17 years old and through interviews and Child Behavior Checklists that were completed by their mothers at corresponding times . The study is ongoing , with a 93 % retention rate to date . RESULTS : According to their mothers ' reports , the 17-year-old daughters and sons of lesbian mothers were rated significantly higher in social , school/academic , and total competence and significantly lower in social problems , rule-breaking , aggressive , and externalizing problem behavior than their age-matched counterparts in Achenbach 's normative sample of American youth . Within the lesbian family sample , no Child Behavior Checklist differences were found among adolescent offspring who were conceived by known , as-yet-unknown , and permanently unknown donors or between offspring whose mothers were still together and offspring whose mothers had separated . CONCLUSIONS : Adolescents who have been reared in lesbian-mother families since birth demonstrate healthy psychological adjustment . These findings have implication s for the clinical care of adolescents and for pediatricians who are consulted on matters that pertain to same-sex parenting | 2,002 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . |
2,002 | 28,472,417 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . | 48,448 | 24,361,638 | Visual memory and learning in extremely low-birth-weight/extremely preterm adolescents compared with controls: a geographic study. | BACKGROUND Contemporary data on visual memory and learning in survivors born extremely preterm ( EP ; < 28 weeks gestation ) or with extremely low birth weight ( ELBW ; < 1,000 g ) are lacking . METHODS Geographically determined cohort study of 298 consecutive EP/ELBW survivors born in 1991 and 1992 , and 262 r and omly selected normal-birth-weight controls . RESULTS Visual learning and memory data were available for 221 ( 74.2 % ) EP/ELBW subjects and 159 ( 60.7 % ) controls . EP/ELBW adolescents exhibited significantly poorer performance across visual memory and learning variables compared with controls . Visual learning and delayed visual memory were particularly problematic and remained so after controlling for visual-motor integration and visual perception and excluding adolescents with neurosensory disability , and /or IQ < 70 . Male EP/ELBW adolescents or those treated with corticosteroids had poorer outcomes . CONCLUSION EP/ELBW adolescents have poorer visual memory and learning outcomes compared with controls , which can not be entirely explained by poor visual perceptual or visual constructional skills or intellectual impairment | 2,002 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . |
2,002 | 28,472,417 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . | 48,449 | 3,144,315 | Effect of pregnancy planning and fertility treatment on cognitive outcomes in children at ages 3 and 5: longitudinal cohort study | Objective To investigate how pregnancy planning , time to conception , and infertility treatment influence cognitive development at ages 3 and 5 . Design Prospect i ve population based cohort study . Setting Millennium Cohort Study in the United Kingdom . Participants 18 818 children recruited at 9 months and followed up at 3 and 5 years . 11 790 singletons with available data on pregnancy , cognitive outcomes , and confounders were included in analyses at age 3 and 12 136 at age 5 . Exposure measures Mothers reported whether the pregnancy was planned , and their feelings when first pregnant ; those in whom the pregnancy was planned provided time to conception , and details of any assisted reproductive technologies . The population was divided into “ unplanned ” ( unplanned and unhappy ) , “ mistimed ” ( unplanned but happy ) , “ planned ” ( planned , time to conception < 12 months ) , “ subfertile ” ( planned , time to conception ≥12 months ) , “ induced ovulation ” ( received clomiphene citrate ) , and “ assisted reproduction ” ( in vitro fertilisation or intracytoplasmic sperm injection ) . The “ planned ” group was the comparison group in all analyses . Outcome measures Three components of the British Ability Scales ( BAS II ) . Naming vocabulary assessed verbal ability at age 3 ; this test was repeated at age 5 with the picture similarities and pattern construction subscales , which measure non-verbal and spatial abilities . Results In unadjusted analyses , the scores on all scales in children from unplanned pregnancies were significantly lower than in those from planned pregnancies — for example , the difference in mean verbal ability score at age 3 was −4.8 ( 95 % confidence interval −6.0 to −3.7 ; P<0.05 ) , equivalent to an average delay of four months . After adjustment for sociodemographic factors these differences were attenuated : −0.3 ( −1.3 to 0.7 ) , equivalent to no delay . Children born after assisted reproduction performed consistently better in verbal ability tests ( 3.8 ( −0.2 to 7.9 ) at age 3 and 3.5 ( 0.2 to 6.8 ) at age 5 ) , which suggests that on average these children are three to four months ahead ; this difference did not completely disappear with adjustment for confounders . Children born after infertility treatment had lower mean scores in non-verbal tests ( −1.2 ( −4.1 to 1.6 ) after assisted reproduction and −1.5 ( −3.5 to 0.4 ) after induced ovulation ) and in spatial ability tests ( −2.7 ( −6.9 to 1.6 ) after assisted reproduction ) , though the differences were not significant . Conclusions Pregnancy planning , subfertility , or assisted reproduction do not adversely affect children ’s cognitive development at age 3 or 5 . The differences observed in the unadjusted analyses are almost entirely explained by marked inequalities in socioeconomic circumstances between the groups | 2,002 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . |
2,002 | 28,472,417 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . | 48,450 | 12,038,562 | Families with children conceived by donor insemination: a follow-up at age twelve. | Growing public awareness of the use of donor insemination ( DI ) to enable infertile couples to become parents has been accompanied by increasing concern regarding the potentially negative consequences for family relationships and child development . Findings are presented from a prospect i ve study of the quality of parenting and psychological adjustment of DI children at age 12 . Thirty-seven DI families , 49 adoptive families , and 91 families with a naturally conceived child were compared on st and ardized interview and question naire measures administered to mothers , fathers , children , and teachers . The differences between DI families and the other family types reflected greater expressive warmth of DI mothers toward their children and less involvement in the discipline of their children by DI fathers . The DI children were well adjusted in terms of their social and emotional development . The findings are discussed with respect to the secrecy surrounding DI and the imbalance in genetic relatedness between the parents and the child | 2,002 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . |
2,002 | 28,472,417 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . | 48,451 | 21,752,151 | Language assessment of non-handicapped twins at 5 years of age. | BACKGROUND The aim of the present study was to determine language levels in twins and singletons born after at least 34 weeks gestation and without identifiable neurological abnormality and to evaluate whether in vitro fertilization ( IVF ) affects language development in twin pregnancies . METHODS A prospect i ve study of a large cohort of all children born between 1 January 2001 and 31 December 2003 was carried out at Gazi University Hospital . All live-born twin pairs in which both twins survived were identified , and a comparable sample of families with pairs of singletons were chosen . The Stanford-Binet Intelligence Scale Form and the translated Turkish form of the Peabody Picture Vocabulary Test were completed at 60 months . RESULTS Even after excluding the most premature twins and those with diagnosable neurological damage , twins performed worse than singletons on language development tests . Twin girls had better scores than twin boys . A statistically significant difference was found between the scores of term and preterm twins . No significant difference was noted when compared according to birth order . Appropriate for gestational age ( AGA ) twins did better than small for gestational age ( SGA ) twins in the test scores . All twin girls did not differ from singleton girls , but all twin boys performed worse than singleton boys . Term twins had similar results with term singletons , but preterm twins had lower scores than preterm singletons . SGA singletons had better scores than SGA twins , while AGA twins and singletons did not differ . When the children were compared with regard to method of conception , IVF children had significantly lower scores on the tests than those in the spontaneous conception group . CONCLUSION It is hoped that the present findings could lead to a more precise assessment of children for speech impairment and , above all , to more efficient preventive intervention . Whatever mechanisms are involved , the present results indicate that twins born as a result of IVF , are at a disadvantage in terms of language development in comparison with spontaneously conceived twins | 2,002 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . |
2,002 | 28,472,417 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . | 48,452 | 24,993,932 | Cognitive and psychomotor development of 5- to 6-year-old singletons born after PGD: a prospective case-controlled matched study. | STUDY QUESTION Do preschool preimplantation genetic diagnosis ( PGD ) children differ in their cognitive and psychomotor development from children born after ICSI and spontaneous conception ( SC ) ? SUMMARY ANSWER The cognitive development of PGD pre-schoolers was comparable to children born after ICSI and SC but motor development differed between ICSI and SC groups . STUDY DESIGN , SIZE DURATION The cognitive abilities and motor skills of 5- to 6-year-old singletons born after PGD ( n = 47 ) were assessed in comparison with 49 ICSI and 48 SC children in a prospect i ve , case-controlled , matched follow-up study between April 2011 and May 2013 . PARTICIPANTS / MATERIAL S , SETTING , METHODS PGD singletons , ICSI and SC children of preschool age were examined with the Wechsler Preschool and Primary Scale of Intelligence ( WPSSI-III-NL ) and the Movement ABC ( M ABC ) . The WPSSI-III-NL revealed scores for Full IQ , Verbal IQ and Performance IQ . The M ABC yields a total score and comprising scores for measurements of balance , dexterity and ball skills . Since embryo biopsy is the only technical difference between the PGD and ICSI procedures , ICSI children were included as controls . These children were part of a Dutch-speaking cohort of children conceived after assisted reproduction technology ( ART ) at the Universitair Ziekenhuis Brussel ( UZ Brussel ) who received longitudinal follow-up . The SC children acted as a second control group similar to the fertile PGD sample and in contrast to the ICSI group . The SC group was recruited through announcements in a variety of media . The children were matched for age , gender , birth order and educational level of the mother . The assessment s carried out for the ART groups were blinded whenever possible . The data were analysed using analysis of covariance ( ANCOVA ) and partial eta squared ( η(2 ) ) , which was used as a measurement of effect size . MAIN RESULTS AND THE ROLE OF CHANCE The overall cognitive development of PGD singletons did not differ from controls [ P = 0.647 , η(2 ) = 0.006 ; 95 % confidence interval ( CI ) ( 0 , 0.043 ) ] . The partial IQ scores for Verbal and Performance intelligence revealed similar results . Analysis of motor development based on the total score as well as subscales did indicate a significant difference between the three conception groups [ P = 0.033 , η(2 ) = 0.050 , 95 % CI ( 0 , 0.124 ) ] . Post hoc analysis indicated that the significant difference was situated between performances of ICSI and SC children . Balance capacities [ P = 0.004 , η(2 ) = 0.079 , 95 % CI ( 0.025 , 0.163 ) ] and its post hoc analysis yielded equivalent results . Motor capacities of PGD singletons , however , did not differ from any of the two other conception groups . LIMITATIONS , REASONS FOR CAUTION Given that we only assessed Caucasian singletons born after PGD , caution is required when drawing more general inferences from our results . The small sample size may be a limitation . A priori power analysis , however , revealed that at least 52 children per group were needed to detect a medium effect and 80 % power using ANCOVA . Originally our sample met this threshold but we had to exclude six cases in order to remove outliers and due to missing data . WIDER IMPLICATION S OF THE FINDINGS Long-term follow-up of children born after embryo biopsy , in this case for PGD , is needed to confirm that the development of these children remains comparable to ICSI and SC children . Our findings do support the safety of the PGD technique and will reassure patients with hereditary genetic diseases regarding the health of their future offspring conceived with PGD . STUDY FUNDING /COMPETING INTERESTS Funding for this study was obtained from the OZR ( Research group of the Vrije Universiteit Brussel ) , the FWO ( Fonds Wetenschappelijk Onderzoek ) and the Wetenschappelijk Fonds Willy Gepts . The UZ Brussel and the Centre of Medical Genetics received funding from pharmaceutical firms for data collection . UZ Brussel and the Centre for Medical Genetics have received many educational grants for organizing the data collection , from IBSA , Ferring , Organon , Shering-Plough , Merck and Merck Belgium . M.B. has received consultancy and speaker 's fees from Organon , Serono Symposia and Merck | 2,002 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . |
2,002 | 28,472,417 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . | 48,453 | 18,281,037 | Neuromotor development and mental health at 5.5 years of age of singletons born at term after intracytoplasmatic sperm injection ICSI: results of a prospective controlled single-blinded study in Germany. | OBJECTIVE To assess the neurodevelopmental health of children born after intracytoplasmatic sperm injection ( ICSI ) . DESIGN Prospect i ve controlled blinded study . SETTING Tertiary care center . PATIENT(S ) A total of 276 term-born singletons conceived by ICSI and 273 matched spontaneously conceived ( SC ) singletons at the age of 5.5 years . MAIN OUTCOME MEASURE(S ) Neuromotor development assessed by a detailed neurologic examination , including the st and ardized motor test MOT 4 - 6 , and emotional/behavioral development and intelligence assessed with the Kaufman- Assessment Battery for Children . RESULT ( S ) There were no significant differences between ICSI children and control children regarding the neurologic examination , motor skills , emotional/behavioral development , and intelligence . CONCLUSION ( S ) The ICSI children born at term develop normally , similar to SC children | 2,002 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . |
2,002 | 28,472,417 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . | 48,454 | 14,667,874 | A prospective longitudinal study of the physical, psychomotor, and intellectual development of singleton children up to 5 years who were conceived by intracytoplasmic sperm injection compared with children conceived spontaneously and by in vitro fertilization. | OBJECTIVE To assess the somatic , psychomotor , and intellectual development of children conceived through intracytoplasmic single sperm injection ( ICSI ) over the whole preschool period . DESIGN Prospect i ve , controlled , cohort study . SETTING Fertility clinic in Brussels , Belgium . PATIENT(S ) Sixty-six ICSI-conceived children prospect ively compared with 52 IVF-conceived and 59 spontaneously conceived children . All children were full-term singletons . INTERVENTION(S ) Home visits by a trained psychologist . St and ardized interviews . Assessment s using the revised Brunet-Lézine scale and the revised Wechsler preschool and primary scale of intelligence . MAIN OUTCOME MEASURE(S ) Physical growth and general health . Formal developmental and intellectual assessment s. RESULT ( S ) Children conceived by ICSI were healthy : no significant differences appeared in the incidence of combined congenital malformations ( 11.3 % ) , health problems ( 44.1 % ) , surgical interventions ( 18.6 % ) , and hospitalizations ( 6.8 % ) , nor for the developmental assessment s ( mean developmental quotient at 9 months : 93.9 ; at 18 months : 102.0 ) . For the intellectual assessment s , the between-group differences disappeared when adjusted for levels of parental education ( mean intelligence quotient at 3 years : 97.0 ; at 5 years : 103.3 ) . CONCLUSION ( S ) This pilot study shows that throughout the preschool period , ICSI-conceived children have psychomotor and intellectual development similar to that of IVF-conceived and spontaneously conceived children . These conclusions need to be confirmed by multicenter studies | 2,002 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . |
2,002 | 28,472,417 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . | 48,455 | 3,702,157 | Fertility treatment and risk of childhood and adolescent mental disorders: register based cohort study | Objective To assess the mental health of children born after fertility treatment by comparing their risk of mental disorders with that of spontaneously conceived children . Design Prospect i ve register based cohort study . Setting Nationwide register based information from Danish National Health Registers cross linked by a unique personal identification number assigned to all citizens in Denmark . Participants All children born in Denmark in 1995 - 2003 with follow-up in 2012 when the children were aged 8 - 17 ; 33 139 children were conceived after fertility treatment and 555 828 children were born after spontaneous conception . Main outcome measures Absolute risks and hazard ratios for overall and specific mental disorders estimated with adjustment for potential confounding variables . Estimated association between the risk of mental disorders and subtypes of procedures , hormone treatments , gamete types , and cause of infertility . Results The risk of mental disorders in children born after in vitro fertilisation or intracytoplasmic sperm injection was low , and was no higher than in spontaneously conceived children , except for a borderline significant increased risk of tic disorders ( hazard ratio 1.40 , 95 % confidence interval 1.01 to 1.95 ; absolute risk 0.3 % ) . In contrast , children born after ovulation induction with or without insemination had low but significantly increased risks of any mental disorder ( 1.20 , 1.11 to 1.31 ; absolute risk 4.1 % ) , autism spectrum disorders ( 1.20 , 1.05 to 1.37 ; 1.5 % ) , hyperkinetic disorders ( 1.23 , 1.08 to 1.40 ; 1.7 % ) , conduct , emotional , or social disorder ( 1.21 , 1.02 to 1.45 ; 0.8 % ) , and tic disorders ( 1.51 , 1.16 to 1.96 ; 0.4 % ) . There was no risk systematic ally related to any specific type of hormone drug treatment . Conclusions There was a small increase in the incidence of mental disorders in children born after ovulation induction/intrauterine insemination . Children born after in vitro fertilisation/intracytoplasmic sperm injection were found to have overall risk comparable with children conceived spontaneously | 2,002 | SUMMARY ANSWER The available high- quality evidence indicates that specific treatments may give rise to different effects on cognitive development , with certain treatments , including ICSI , associated with cognitive impairment . | STUDY QUESTION Does fertility treatment influence cognitive ability in school aged children , and does the impact vary with the type of treatment ?
WHAT IS KNOWN ALREADY Previous review s of the literature concerning cognitive outcomes among children conceived with medical assistance have concluded that study findings are generally ' reassuring ' , but limited attention has been paid to the quality of this research .
In addition , no review has separately assessed the range of treatment modalities available , which vary in invasiveness , and thus , potentially , in their effects on developmental outcomes . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,456 | 20,439,663 | Quality of life after volar plate fixation of articular fractures of the distal part of the radius. | BACKGROUND Outcome measurement following surgery is increasingly the focus of attention in current health-care debates because of the rising costs of medical care and the large variety of operative options . The purpose of the present study was to correlate quality of life after volar locked plate fixation of unstable intra-articular distal radial fractures with functional and radiographic results as well as with quality -of-life data from population norms . METHODS Fifty-four consecutive patients with intra-articular distal radial fractures and a mean age of sixty-three years were managed with a volar locked plate system . Range of motion , grip strength , and radiographs were assessed at a mean of six years postoperatively . The wrist-scoring systems of Gartl and and Werley and Castaing were adopted for the assessment of objective outcomes . The Disabilities of the Arm , Shoulder and H and and Short Form-36 question naires were completed as subjective outcome measures , and the results were compared with United States and Austrian population norms . RESULTS Functional improvement continued for two years postoperatively . At the time of the latest follow-up , > 90 % of all patients had achieved good or excellent results according to the scoring systems of Gartl and and Werley and Castaing . The results of the Short Form-36 question naire were similar to the United States and Austrian population norms . The mean Disabilities of the Arm , Shoulder and H and score was 5 points at two years , and it increased to 13 points at six years . The twenty patients with radiocarpal arthritis had significantly poorer results in the physical component summary measure of the Short Form-36 question naire ( p = 0.012 ) . CONCLUSIONS The results of the present single-center study show that , following distal radial fracture fixation , wrist arthritis may affect the patient 's subjective well-being , as documented with the Short Form-36 , without influencing the functional outcome . Well- design ed longitudinal clinical trials are needed to confirm the findings of the present investigation in terms of quality of life after surgical treatment of intra-articular distal radial fractures | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,457 | 2,908,563 | Treatment of reducible unstable fractures of the distal radius in adults: a randomised controlled trial of De Palma percutaneous pinning versus bridging external fixation | Background At present , there is no conclusive evidence regarding the best treatment method for reducible unstable fractures of the distal radius . This study compared the effectiveness of two methods used in surgical treatment of such fractures : percutaneous pinning and external fixation . Methods We r and omly allocated 100 patients into two groups treated surgically with modified De Palma percutaneous pinning and bridging external fixation . Independent but not blinded evaluators administered the DASH quality -of-life question naire at postoperative months 6 and 24 , performed functional assessment of pain , range of motion , and palm grip strength , and radiographic examinations ( volar and radial angle , and height of the radius ) before the operation , immediately afterwards , and at 6 and 24 months postoperative . Modified De Palma percutaneous pinning patients used an above-elbow cast whereas external fixation group had unrestricted elbow motion after surgery . Patients who for any reason demonstrated treatment failure or required additional interventions were followed up and their results were included in the group into which these patients had initially been r and omised according to the intention-to-treat principle . A significance level of 5 % ( alpha = 0.05 ) . was used for all statistical tests , such that tests presenting a p-value less than 0.05 were considered statistically significant . Results Ninety one ( 58.8 mean age and 66 participants were female ) were included in the final assessment at 24 months . The DASH question naire evaluation showed a statistically significant result favouring the De Palma group ( mean difference = -7.1 p = 0.044 ) after six months , but this was not maintained at 24 months . There were no statistically differences between the groups with respect to palm grip strength . Analysis of the range-of-motion limitation index ( uninjured side minus affected side motion of ) showed a statistical difference ( mean difference = 2.4 p = 0.043 ) favoring the external fixator group with regard to the supination movement 6 months after the operation ; however , this was not maintained at 24 months . The final results of the radiographic evaluation were similar for the two groups . Overall , five patients developed complications : two with De Palma pinning and three with external fixation . Conclusion There was a small statistically significant difference favouring the De Palma method in early functional at 6 months according to the DASH question naire , and for supination movement favouring the fixator group . However , both were not clinical relevant . By 24 months the groups were similar for all outcomes Trial registration Current Controlled Trials IS RCT | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,458 | 18,332,014 | WHICH QUESTIONNAIRE IS BEST? THE RELIABILITY, VALIDITY AND EASE OF USE OF THE PATIENT EVALUATION MEASURE, THE DISABILITIES OF THE ARM, SHOULDER AND HAND AND THE MICHIGAN HAND OUTCOME MEASURE | The Patient Evaluation Measure ( PEM ) , The Michigan H and Outcome Question naire ( MHQ ) and the Disabilities of the Arm , Shoulder and H and ( DASH ) score were assessed independent of their originators for reliability , construct and criterion validity and acceptability , using an ease of use question naire . These were administered in r and om order to 100 patients with different h and and wrist disorders and with different impairments of movement , pain , sensation and strength . The internal consistency of all three question naires was very high suggesting redundancy in the questions . All question naires were reproducible and valid for finger and wrist disorders , but less for nerve disorders . All had poor construct validity . The PEM was the easiest to underst and and complete , taking the least time . Correlation between the scales is high and conversion equations were calculated . All three are reliable and reproducible patient completed question naires , but the PEM is the easiest to use . The validity of all is suspected for nerve disorders | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,459 | 18,757,963 | Bridging external fixation and supplementary Kirschner-wire fixation versus volar locked plating for unstable fractures of the distal radius: a randomised, prospective trial. | We performed a prospect i ve , r and omised trial to evaluate the outcome after surgery of displaced , unstable fractures of the distal radius . A total of 280 consecutive patients were enrolled in a prospect i ve data base and 88 identified who met the inclusion criteria for surgery . They were r and omised to receive either bridging external fixation with supplementary Kirschner-wire fixation or volar-locked plating with screws . Both groups were similar in terms of age , gender , h and dominance , fracture pattern , socio-economic status and medical co-morbidities . Although the patients treated by volar plating had a statistically significant early improvement in the range of movement of the wrist , this advantage diminished with time and in absolute terms the difference in range of movement was clinical ly unimportant . Radiologically , there were no clinical ly significant differences in the reductions , although more patients with AO/OTA ( Orthopaedic Trauma Association ) type C fractures were allocated to the external fixation group . The function at one year was similar in the two groups . No clear advantage could be demonstrated with either treatment but fewer re-operations were required in the external fixation group | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,460 | 3,501,800 | Use of Condition-Specific Patient-Reported Outcome Measures in Clinical Trials among Patients with Wrist Osteoarthritis: A Systematic Review | Background . This paper aim ed to identify condition-specific patient-reported outcome measures used in clinical trials among people with wrist osteoarthritis and summarise empirical peer- review ed evidence supporting their reliability , validity , and responsiveness to change . Methods . A systematic review of r and omised controlled trials among people with wrist osteoarthritis was undertaken . Studies reporting reliability , validity , or responsiveness were identified using a systematic reverse citation trail audit procedure . Psychometric properties of the instruments were examined against predefined criteria and summarised . Results . Thirteen clinical trials met inclusion criteria . The most common patient-reported outcome was the disabilities of the arm , shoulder , and h and question naire ( DASH ) . The DASH , the Michigan H and Outcomes Question naire ( MHQ ) , the Patient Evaluation Measure ( PEM ) , and the Patient-Reported Wrist Evaluation ( PRWE ) had evidence supporting their reliability , validity , and responsiveness . A post-hoc review of excluded studies revealed the AUSCAN Osteoarthritis H and Index as another suitable instrument that had favourable reliability , validity , and responsiveness . Conclusions . The DASH , MHQ , and AUSCAN Osteoarthritis H and Index instruments were supported by the most favourable empirical evidence for validity , reliability , and responsiveness . The PEM and PRWE also had favourable empirical evidence reported for these elements . Further psychometric testing of these instruments among people with wrist osteoarthritis is warranted | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,461 | 3,230,001 | Wrist function recovers more rapidly after volar locked plating than after external fixation but the outcomes are similar after 1 year | Background and purpose Promising results have been reported after volar locked plating of unstable dorsally displaced distal radius fractures . We investigated whether volar locked plating results in better patient-perceived , objective functional and radiographic outcomes compared to the less invasive external fixation . Patients and methods 63 patients under 70 years of age , with an unstable extra-articular or non-comminuted intra-articular dorsally displaced distal radius fracture , were r and omized to volar locked plating ( n = 33 ) or bridging external fixation . Patient-perceived outcome was assessed with the Disability of the Arm , Shoulder , and H and ( DASH ) question naire and the Patient-Rated Wrist Evaluation ( PRWE ) question naire . Results At 3 and 6 months , the volar plate group had better DASH and PRWE scores but at 12 months the scores were similar . Objective function , measured as grip strength and range of movement , was superior in the volar plate group but the differences diminished and were small at 12 months . Axial length and volar tilt were retained slightly better in the volar plate group . Interpretation Volar plate fixation is more advantageous than external fixation , in the early rehabilitation period | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,462 | 2,823,185 | Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures | Background and purpose In unstable distal radial fractures that are impossible to reduce or to maintain in reduced position , the treatment of choice is operation . The type of operation and the choice of implant , however , is a matter of discussion . Our aim was to investigate whether open reduction and internal fixation would produce a better result than traditional external fixation . Methods 50 patients with an unstable or comminute distal radius fracture were r and omized to either closed reduction and bridging external fixation , or open reduction and internal fixation using the TriMed system . The primary outcome parameter was grip strength , but the patients were followed for 1 year with objective clinical assessment , subjective outcome using DASH , and radiographic examination . Results At 1 year postoperatively , grip strength was 90 % ( SD 16 ) of the uninjured side in the internal fixation group and 78 % ( 17 ) in the external fixation group . Pronation/supination was 150 ° ( 15 ) in the internal fixation group and 136 ° ( 20 ) in the external fixation group at 1 year . There were no differences in DASH scores or in radiographic parameters . 5 patients in the external fixation group were reoperated due to malunion , as compared to 1 in the internal fixation group . 7 other cases were classified as radiographic malunion : 5 in the external fixation group and 2 in the internal fixation group . Interpretation Internal fixation gave better grip strength and a better range of motion at 1 year , and tended to have less malunions than external fixation . No difference could be found regarding subjective outcome | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,463 | 18,539,672 | Treatment of intra-articular fractures of the distal radius: fluoroscopic or arthroscopic reduction? | In a r and omised prospect i ve study , 20 patients with intra-articular fractures of the distal radius underwent arthroscopically- and fluoroscopically-assisted reduction and external fixation plus percutaneous pinning . Another group of 20 patients with the same fracture characteristics underwent fluoroscopically-assisted reduction alone and external fixation plus percutaneous pinning . The patients were evaluated clinical ly and radiologically at follow-up of 24 months . The Disabilities of the Arm , Shoulder , and H and ( DASH ) question naire and modified Mayo wrist score were used at 3 , 9 , 12 and 24 months postoperatively . In the arthroscopically- and fluoroscopically-assisted group , triangular fibrocartilage complex tears were found in 12 patients ( 60 % ) , complete or incomplete scapholunate ligament tears in nine ( 45 % ) , and lunotriquetral ligament tears in four ( 20 % ) . They were treated either arthroscopically or by open operation . Patients who underwent arthroscopically- and fluoroscopically-assisted treatment had significantly better supination , extension and flexion at all time points than those who had fluoroscopically-assisted surgery . The mean DASH scores were similar for both groups at 24 months , whereas the difference in the mean modified Mayo wrist scores remained statistically significant . Although the groups are small , it is clear that the addition of arthroscopy to the fluoroscopically-assisted treatment of intra-articular distal radius fractures improves the outcome . Better treatment of associated intra-articular injuries might also have been a reason for the improved outcome | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,464 | 20,358,335 | Does an ulnar styloid fracture interfere with the results of a distal radius fracture? | Background The ulnar styloid is a supportive structure for the capsular ligament complex of the distal radioulnar joint . The relation between fractures of the ulna and distal radius is not clear , especially in regard to whether ulnar fractures predict worse outcomes for distal radius fractures . The objective of this study was to analyze the influence of ulnar styloid fractures in patients with reducible and unstable distal radius fractures . Methods A total of 100 patients with unstable and reducible distal radius fractures , with or without an ulnar styloid fracture , were r and omly assigned to treatment with transarticular bridging external fixation or transulnar percutaneous pinning . Follow-up was obtained for 91 patients . For the secondary data analysis , three patient cohorts were created : a no ulnar styloid fracture group with the radius fracture treated by pinning or external fixation ( n = 30 ) ; an ulnar styloid fracture with radius fracture group treated by external fixation ( n = 31 ) ; and an ulnar styloid fracture with radius fracture treated by pinning ( n = 30 ) . Functional and radiological outcomes were measured at 6 and 24 months . Functional outcome measures included wrist pain ( visual analogue scale ) and the Disabilities of the Arm , Shoulder , and H and ( DASH ) question naire . Results At 24 months , patients with both fractures had worse wrist pain and worse scores on the DASH question naire than the patients with an isolated distal radius fracture ; and those treated by pinning had less wrist pain and showed better scores on the DASH question naire than the patients treated by fixation . Conclusions Ulnar styloid fracture may be a predictive factor of worse functional outcome for distal radius fracture . Pinning and above-the-elbow casting , used to treat ulnar styloid fractures , led to better function than fixation | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,465 | 12,352,567 | Open Reduction and Internal Fixation of Unstable Distal Radius Fractures: Results Using the Trimed Fixation System | Objective The purpose of this study was to evaluate the early results of patients with displaced and unstable distal radius fractures treated with fragment-specific fixation . Design Prospect i ve and consecutive . Setting Private orthopaedic practice . Patients / Participants Twenty-five patients with 27 fractures with an average follow-up of 29 months ( range 24–36 months ) treated with fragment-specific fixation for unstable radius fractures . Main Outcome Measurements Clinical and radiographic examination . Disabilities of the arm , h and , and shoulder and patient-rated wrist evaluation outcome measures . Results Patients had an average 61 ° of dorsiflexion and 54 ° of palmarflexion at the wrist . Twenty-five fractures healed in acceptable alignment , with one loss of reduction and one patient death . Mean ± st and ard deviation DASH score was 17 ± 18 , and PRWE score was 19 ± 22 . Conclusion Unstable distal radius fractures can be reliably and anatomically reduced and stabilized using fragment-specific fixation . Fixation of markedly comminuted fractures is secure enough to allow immediate motion and does not require casting or external fixation . Preliminary clinical and radiographic results are excellent , and patient satisfaction is high . Anatomic reduction with early motion can be achieved in a routine fashion on unstable distal radius fractures using the described technique | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,466 | 23,336,124 | Effect of mirror therapy on hand function in patients with hand orthopaedic injuries: a randomized controlled trial | Abstract Purpose : To investigate the effects of mirror therapy ( MT ) in restoring h and function in patients with active range of motion ( AROM ) impairments following orthopaedic injuries . Method : In a r and omized controlled trial ( RCT ) , 30 patients with active ROM impairment ( 8 men and 22 women ; mean age : 38 years ) were measured . Intervention group received MT , 30 min a day , five days a week for three weeks , as well , half an hour conventional rehabilitation after each MT session . Patients in the control group received the same treatment programme , but instead of mirror , they observed directly the affected h and . In addition , both groups performed a 15 min home programme , including MT for intervention group and AROM with direct observation of the affected h and for control group , twice daily . Outcome measures , including total active motion ( TAM ) and Disabilities of Arm , Shoulder and H and ( DASH ) question naire , were administered pre- and post-treatment and three weeks later . This study was registered as an RCT , no. NCT01503762 in http:// clinical trials.gov/. Results : Final analysis was performed on 23 patients . The mean ( SD ) changes at post-test from baseline TAM was 154 ( 32 ) in the MT ( N = 12 ) and 61 ( 24 ) in the control group ( N = 11 ) ; mean difference ( 95 % CI ) 93 ( 68–118 ) , p = 0.001 . The mean ( SD ) change at post-test from baseline DASH was −34 ( 7 ) in the MT ( N = 12 ) and −15 ( 11 ) in the control group ( N = 11 ) ; mean difference ( 95 % CI ) 19 ( −27 to −11 ) , p = 0.001 . Conclusions : Despite significant improvement at post-test in both groups and maintenance of improvement during the follow-up period , MT combined with conventional rehabilitation produced more improvement in h and function than control group . Implication s for Rehabilitation H and orthopaedic injuries can result in disabilities in activities of daily living . Mirror therapy ( MT ) provides perception of two healthy limbs through reflection of the healthy limb as the injured limb . In a r and omized controlled trial , our study shows positive effects of MT combined with a classical rehabilitation programme to improve h and function in patients with orthopaedic injuries | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,467 | 16,270,189 | [Postoperative CT-controlled results of renewed osteosynthesis using screw fixation for acute scaphoid fractures]. | BACKGROUND Currently screw fixation of the scaphoid is a well-established method to treat unstable scaphoid fractures . PATIENTS AND METHODS Between June 1995 and December 2000 , 68 patients with an unstable acute scaphoid fracture were treated with screw fixation ; 46 patients were reexamined on an average 35 months postoperatively . Range of motion and grip strength ( Jamar dynamometer ) were measured . The total data rating result ed from the Krimmer wrist score . RESULTS The subjective results were evaluated with the DASH question naire . The average postoperative pain score was documented with a visual analogous pain scale from zero to 100 ( VAS 0 - 100 ) . X-rays as well as computed tomography were performed postoperatively . The average range of motion was 124 degrees for extension/flexion ( 92 % of the opposite site ) , 57 degrees for radial/ulnarduction ( = 90 % ) , and 177 degrees for pronation/supination ( = 98 % ) . Postoperative strength was 47 kg ( = 90 % of the opposite site ) . The postoperative pain score was 13 ( 0 - 100 ) after stress and 2 during resting conditions . Bony consolidation was reached in 44 cases . The Krimmer wrist score demonstrated a very good result in 39 cases , a good result in 5 cases , and a satisfactory result in 3 cases . The average DASH score was 8.3 points . CONCLUSIONS The results demonstrate the reliability of internal screw fixation as treatment for acute scaphoid fractures . Functional results as well as subjective satisfaction of the patients are very good . Postoperative CT scans help to evaluate exact bony consolidation , position of the screw , and postoperative morphology of the scaphoid | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,468 | 23,529,145 | Cross-education for improving strength and mobility after distal radius fractures: a randomized controlled trial. | OBJECTIVE To evaluate the effects of cross-education ( contralateral effect of unilateral strength training ) during recovery from unilateral distal radius fractures on muscle strength , range of motion ( ROM ) , and function . DESIGN R and omized controlled trial ( 26-wk follow-up ) . SETTING Hospital , orthopedic fracture clinic . PARTICIPANTS Women older than 50 years with a unilateral distal radius fracture . Fifty-one participants were r and omized and 39 participants were included in the final data analysis . INTERVENTIONS Participants were r and omized to st and ard rehabilitation ( Control ) or st and ard rehabilitation plus strength training ( Train ) . St and ard rehabilitation included forearm casting for 40.4±6.2 days and h and exercises for the fractured extremity . Nonfractured h and strength training for the training group began immediately postfracture and was conducted at home 3 times/week for 26 weeks . MAIN OUTCOME MEASURES The primary outcome measure was peak force ( h and grip dynamometer ) . Secondary outcomes were ROM ( flexion/extension ; supination/pronation ) via goniometer and the Patient Rated Wrist Evaluation question naire score for the fractured arm . RESULTS For the fractured h and , the training group ( 17.3±7.4 kg ) was significantly stronger than the control group ( 11.8±5.8 kg ) at 12 weeks postfracture ( P<.017 ) . There were no significant strength differences between the training and control groups at 9 ( 12.5±8.2 kg ; 11.3±6.9 kg ) or 26 weeks ( 23.0±7.6 kg ; 19.6±5.5 kg ) postfracture , respectively . Fractured h and ROM showed that the training group had significantly improved wrist flexion/extension ( 100.5 ° ±19.2 ° ) than the control group ( 80.2 ° ±18.7 ° ) at 12 weeks postfracture ( P<.017 ) . There were no significant differences between the training and control groups for flexion/extension ROM at 9 ( 78.0 ° ±20.7 ° ; 81.7 ° ±25.7 ° ) or 26 weeks ( 104.4 ° ±15.5 ° ; 106.0 ° ±26.5 ° ) or supination/pronation ROM at 9 ( 153.9 ° ±23.9 ° ; 151.8 ° ±33.0 ° ) , 12 ( 170.9 ° ±9.3 ° ; 156.7 ° ±20.8 ° ) or 26 weeks ( 169.4 ° ±11.9 ° ; 162.8 ° ±18.1 ° ) , respectively . There were no significant differences in Patient Rated Wrist Evaluation question naire scores between the training and control groups at 9 ( 54.2±39.0 ; 65.2±28.9 ) , 12 ( 36.4±37.2 ; 46.2±35.3 ) , or 26 weeks ( 23.6±25.6 ; 19.4±16.5 ) , respectively . CONCLUSIONS Strength training for the nonfractured limb after a distal radius fracture was associated with improved strength and ROM in the fractured limb at 12 weeks postfracture . These results have important implication s for rehabilitation strategies after unilateral injuries | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,469 | 16,819,684 | Wrist-bridging versus non-bridging external fixation for displaced distal radius fractures: A randomized assessor-blind clinical trial of 38 patients followed for 1 year | Background Non-bridging external fixation has been introduced to achieve better fracture fixation and functional outcomes in distal radius fractures , but has not been specifically evaluated in a r and omized study in the elderly . The purpose of this trial was to compare wrist-bridging and non-bridging external fixation for displaced distal radius fractures . Method The inclusion criteria were women ≥ 50 or men ≥ 60 years , acute extraarticular or intraarticular fracture , and dorsal angulation of ≥20 ° or ulnar variance ≥ 5 mm . The patients completed the disabilities of the arm , shoulder and h and ( DASH ) question naire before and at 10 , 26 and 52 weeks after surgery . Pain ( visual analog scale ) , range of motion and grip strength were measured by a blinded assessor . Results 38 patients ( mean age 71 years , 31 women ) were r and omized at surgery ( 19 to each group ) . Mean operating time was shorter for wrist-bridging fixation by 10 ( 95 % CI 3–17 ) min . There was no significant difference in DASH scores between the groups . No statistically significant differences in pain score , range of motion , grip strength , or patient satisfaction were found . The non-bridging group had a significantly better radial length at 52 weeks ; mean difference in change in ulnar variance from baseline was 1.4 ( 95 % CI 0.1–2.7 ) mm ( p = 0.04 ) . Volar tilt and radial inclination were similar in both groups . Interpretation For moderately or severely displaced distal radius fractures in the elderly , non-bridging external fixation had no clinical ly relevant advantage over wrist-bridging fixation but was more effective in maintaining radial length | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,470 | 17,124,450 | [Plate fixation with locking screw for distal fractures of the radius]. | PURPOSE OF THE STUDY Fractures of the distal radius are common . No one implant has demonstrated superior efficacy in terms of maintaining the reduction over time . We report our experience with plate fixation using a locking screw . MATERIAL AND METHODS Between September 2003 and June 2004 , 67 displaced fractures of the distal radius were treated by plate fixation using the LCP-DRP 2.4 ( Synthès ) . Three different plates ( anterior , posterior , and external ) were used . The patients wore a removable anatomic brace for three weeks . Self-controlled rehabilitation exercises began directly after surgery with mobilization of the digital chains . The Fern and ez , Castaing and AO classifications were noted . Ulnar variance , anteversion of the radial glenoid , radial slope and the alpha angle were measured intraoperatively and at last follow-up to assess maintenance of reduction over time . The DASH test and Green and O'Brien and PRWE scores were used to assess clinical outcome . RESULTS Mean follow-up was eight months . Mean age was 55.8 years . Eight patients were lost to follow-up . The analysis included 59 patients who could respond to the question naires . Bone healing was achieved at six weeks . There were no cases of secondary displacement nor loss of reduction . The Green and O'Brien score was good or very good for 85 % . The mean DASH was 20.6 and the mean PRWE 32.8 . DISCUSSION The appropriate fixation method for distal fractures of the radius remains a controversial issue , leading to a variety of material s and fixation methods . Primary stability achieved with the locking screw in a plate enables early mobilization associated with more rapid recovery of function . The absence of secondary displacement , irrespective of the quality of the underlying bone enabled us to achieve equivalent results in young patients and older patients with osteoporotic bone . This study also confirmed the preference for the anterior approach , irrespective of the direction of the displacement . To date , no other material has enabled equivalent results . This is a major achievement in terms of fixation stability | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,471 | 16,969,651 | [Distal radius fracture. Correlation between radiological and functional results]. | BACKGROUND The purpose of the present study was to investigate the influence of the radiological parameters on the functional outcome of patients with a fracture of the distal radius and to find out to which extent a deformity can be tolerated . PATIENTS AND METHODS A total of 344 patients with an isolated fracture of the distal radius were treated during a 3-year period ; 211 of them were evaluated at an average of 16 months after the accident according to the score of Gartl and and Werley as modified by Sarmiento . Furthermore , we developed our own score for evaluating the influence of radiological parameters on the functional outcome . RESULTS According to the AO classification , there were 20 patients with an A2 , 71 an A3 , 11 a B , 35 a C1 , 44 a C2 , and 30 a C3 fracture . Of 211 patients , 28 ( 13 % ) had a step-off in the articular surface of over 1 mm , result ing in a 24 % reduction of the range of motion compared to the non-injured wrist ( p<0.05 ) . Patients with a radial shortening of more than 3 mm ( n=12 ) had a 21 % reduction of pro- and supination compared to the non-injured side ( p<0.05 ) . The radial tilt and the palmar inclination did not have a direct influence on the functional outcome . Patients treated with K-wire pinning and with an initial palmar inclination of less then -15 degrees had a significantly higher secondary loss of palmar inclination of 9 degrees compared to all others ( p<0.05 ) at the final follow-up . CONCLUSION The main radiological factors influencing the functional outcome of fractures of the distal radius are radial shortening and a step-off in the articular surface | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,472 | 18,971,728 | A Comparative Study of Fragment-Specific versus Volar Plate Fixation of Distal Radius Fractures | Background : There are many plating systems available for treating distal radius fractures , and deciding which to use can be difficult . This prospect i ve cohort study compared outcomes of two commonly used fixation systems : fragment-specific fixation and a fixed-angle volar locking plate system . Methods : Consecutive distal radius fractures were prospect ively evaluated in a fragment-specific fixation cohort and a volar locking plate system cohort . Radiographic , functional , and patient-rated outcomes were collected immediately postoperatively and at 6 and 12 months postoperatively . Complications were recorded and grade d by severity . Results : Fourteen distal radius fractures treated with fragment-specific fixation and 85 treated with the volar locking plate system were enrolled . Radial inclination was similar in both cohorts ( 23 degrees versus 25 degrees ) ; however , volar tilt was worse in the fragment-specific fixation cohort ( −10 degrees versus 10 degrees , p < 0.05 ) . The majority ( 63 percent ) of the fragment-specific fixation cohort demonstrated a loss of relative radial length . Grip strength , pinch strength , Michigan H and Outcomes Question naire scores , and most range of motion measurements were superior in the volar locking plate system cohort at 6 months , although not all differences were statistically significant . By 12 months the differences in functional and patient-rated outcomes were smaller , suggesting that the fragment-specific fixation cohort tended to reach the outcomes of the volar locking plate system cohort over time . Complications requiring reoperation were higher in the fragment-specific fixation cohort ( p < 0.05 ) . Conclusions : The volar locking plate system results in more stable fixation and better objective and subjective outcomes early in the postoperative period . It has fewer complications requiring reoperation than fragment-specific fixation | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,473 | 22,150,146 | Randomised study of non-bridging external fixation compared with intramedullary fixation of unstable distal radial fractures | Abstract This is a r and omised study to compare two types of osteo synthesis to mobilise wrists after distal fractures of the radius . Inclusion criteria were Older type 2 and 3 fractures . External fixation was managed with Hoffmann II compact non-bridging . Internal fixation was managed with Micronail . Patients were followed up for 12 weeks . The primary outcome was the results of the disabilities of arm , shoulder and h and ( DASH ) question naire . The secondary outcomes were answers to the patient-rated wrist evaluation ( PRWE ) , grip strength , satisfaction , radial length , and volar tilt . Thirty patients were r and omised to have external fixation and 31 to have internal fixation . There were no significant differences in DASH score . Internal fixation gave significantly better grip strength at five ( p = 0.00 ) and 12 weeks ( p = 0.03 ) . The operating time was significantly shorter ( p = 0.00 ) when non-bridging external fixation was used , and there were minor radiological differences . An activity-based costing analysis showed that external fixation cost three times more overall | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,474 | 20,823,169 | Cast versus splint in children with minimally angulated fractures of the distal radius: a randomized controlled trial | Background : Minimally angulated fractures of the distal radius are common in children and have excellent outcomes . We conducted a r and omized controlled trial to determine whether the use of a prefabricated splint is as effective as a cast in the recovery of physical function . Methods : We included 96 children 5 to 12 years of age who were treated for a minimally angulated ( ≤ 15 ° ) greenstick or transverse fracture of the wrist between April 2007 and September 2009 at a tertiary care pediatric hospital . Participants were r and omly assigned to receive either a prefabricated wrist splint or a short arm cast for four weeks . The primary outcome was physical function at six weeks , measured using the performance version of the Activities Scale for Kids . Additional outcomes included the degree of angulation , range of motion , grip strength and complications . Results : Of the 96 children , 46 received a splint and 50 a cast . The mean Activities Scale for Kids score at six weeks was 92.8 in the splint group and 91.4 in the cast group ( difference 1.44 , 95 % confidence interval [ CI ] −1.75 to 4.62 ) . Thus , the null hypothesis that the splint is less effective by at least seven points was rejected . The between-group difference in angulation at four weeks was not statistically significant ( 9.85 ° in the splint group and 8.20 ° in the cast group ; mean difference 1.65 ° , 95 % CI −1.82 ° to 5.11 ° ) , nor was the between-group differences in range of motion , grip strength and complications . Interpretation : In children with minimally angulated fractures of the distal radius , use of a splint was as effective as a cast with respect to the recovery of physical function . In addition , the devices were comparable in terms of the maintenance of fracture stability and the occurrence of complications . ( Clinical Trials.gov trial register no. NCT00610220 . | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,475 | 14,630,841 | Norian SRS cement compared with conventional fixation in distal radial fractures. A randomized study. | BACKGROUND A prospect i ve , r and omized multicenter study was conducted to evaluate closed reduction and immobilization with and without Norian SRS ( Skeletal Repair System ) cement in the management of distal radial fractures . Norian SRS is a calcium-phosphate bone cement that is injectable , hardens in situ , and cures by a crystallization reaction to form dahllite , a carbonated apatite equivalent to bone mineral . METHODS A total of 323 patients with a distal radial fracture were r and omized to treatment with or without Norian SRS cement . Stratification factors included fracture type ( intra-articular or extra-articular ) , h and dominance , bone density , and the surgeon 's preferred conventional treatment ( cast or external fixator ) . The subjects receiving Norian SRS underwent a closed reduction followed by injection of the cement percutaneously or through a limited open approach . Wrist motion , beginning two weeks postoperatively , was encouraged . Control subjects , who had not received a Norian SRS injection , underwent closed reduction and application of a cast or external fixator for six to eight weeks . Supplemental Kirschner wires were used in specific instances in both groups . Patients were followed clinical ly and radiographically at one , two , four , and between six and eight weeks and at three , six , and twelve months . Patients rated pain and the function of the h and with use of a visual analog scale . Quality of life was assessed with use of the Short Form-36 ( SF-36 ) health status question naire . Complications were recorded . RESULTS Significant clinical differences were seen at six to eight weeks postoperatively , with better grip strength , wrist range of motion , digital motion , use of the h and , and social and emotional function , and less swelling in the patients treated with Norian SRS than in the control group ( p < 0.05 ) . By three months , these differences had normalized except for digital motion , which remained significantly better in the group treated with Norian SRS ( p = 0.015 ) . At one year , no clinical differences were detected . Radiographically , the average change in ulnar variance was greater in the patients treated with Norian SRS ( + 2.0 mm ) than in the control group ( + 1.4 mm ) ( p < 0.02 ) . No differences were seen in the total number of complications , including loss of reduction . The infection rate , however , was significantly higher ( p < 0.001 ) in the control group ( 16.7 % ) than in the group treated with Norian SRS ( 2.5 % ) and the infections were always related to external fixator pins or Kirschner wires . Four patients with intra-articular extravasation of cement were identified ; no sequelae were observed at twenty-four months . Cement was seen in extraosseous locations in 112 ( 70 % ) of the SRS-treated patients ; loss of reduction was highest in this subgroup ( 37 % ) . The extraosseous material had disappeared in eighty-three of the 112 patients by twelve months . CONCLUSIONS Our results indicate that fixation of a distal radial fracture with Norian SRS cement may allow for accelerated rehabilitation . A limited open approach and supplemental fixation with Kirschner wires are recommended . Additional or alternate fixation is necessary for complex articular fractures | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,476 | 19,318,865 | A Comparative Study of Clinical and Radiologic Outcomes of Unstable Colles Type Distal Radius Fractures in Patients Older Than 70 Years: Nonoperative Treatment Versus Volar Locking Plating | Objectives : To compare final functional and radiographic outcomes of closed reduction and casting ( CAST ) with open reduction and internal fixation ( ORIF ) with palmar locking plate for unstable Colles type distal radius fractures ( DRFs ) in low-dem and patients older than 70 years . Design : Retrospective , clinical study . Setting : Level 1 university trauma center . Patients : Over a mean period of 4 years and 7 months , 130 consecutive patients older than 70 years were treated for an unstable dorsally displaced DRF of which 114 or 87 % were followed for 1 year or longer . Intervention : ORIF ( n = 53 ) using volar locking plate or closed reduction and casting ( n = 61 ) . Main Outcome Measurements : Objective and subjective functional results ( active range of motion ; grip strength ; disabilities of the arm , shoulder and h and ( DASH ) score ; patient-rated wrist evaluation ( PRWE ) score ; visual analog scale ; and Green and O'Brien score ) and radiographic assessment ( dorsal tilt , radial inclination , radial shortening , fracture union , and posttraumatic arthritis ) were assessed . Results : At final follow-up , there was no significant difference between the 2 groups for mean ranges of motion , grip strength , DASH score , PRWE score , and Green and O'Brien score . Pain level was significantly less for the patients in the CAST group . An obvious clinical deformity was present in 77 % of cast group and none in the ORIF group . At final follow-up , in the ORIF group , there was a mean loss of dorsal tilt of 1.3 degrees , radial inclination of 0.3 degrees , and radial length of 0.5 mm compared with the postoperative measurements . No primary acceptable reduction was achieved in 44 % of the CAST group . At final follow-up , in the CAST group , dorsal tilt , radial inclination , and radial shortening averaged −24.4 ± 12 degrees , 19.2 ± 6.5 degrees , and + 3.9 ± 2.7 mm , respectively . Malunion occurred in 89 % primarily reduced fractures . Dorsal tilt , radial inclination , and radial shortening were significantly better in the ORIF group . Conclusions : Radiographic results ( dorsal tilt , radial inclination , and radial shortening ) after unstable dorsally displaced DRFs are significantly better in patients treated by ORIF using a volar fixed-angle plate rather than those treated by cast immobilization ( P < 0.05 ) . At a mean follow-up time of 4 years and 7 months , the clinical outcomes of active range of motion , the PRWE , DASH , and Green and O'Brien scores do not differ between the 2 methods of treatment . The pain level was significantly less in the CAST group ( P < 0.05 ) , and this group experienced no complications . There was no difference between the subjective and functional outcomes for the surgical and the nonsurgical treatments in a cohort of patients older than 70 years . Unsatisfactory radiographic outcome in older patients does not necessarily translate into unsatisfactory functional outcome . Nonoperative treatment may be the preferred method of treatment in this age group | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,477 | 12,531,669 | Minimally Displaced Colles’ Fractures: A Prospective Randomized Trial of Treatment With a Wrist Splint or a Plaster Cast | Sixty-six adult patients with minimally displaced distal radial fractures were r and omly assigned to treatment with either a plaster cast or a lightweight removable wrist splint . Outcome assessment was by clinical and radiological evaluation and an independent physiotherapy assessment . There were significant differences between the treatments for cast satisfaction , cast problems and the functional assessment score at 6 weeks , with the removable splint scoring better in all cases | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,478 | 16,136,342 | A randomised clinical trial of activity-focussed physiotherapy on patients with distal radius fractures | Introduction : Physiotherapy is considered by some authorities to be an important aspect of management in patients following distal radius fractures . There is evidence of improvement in impairment with physiotherapy ; however , there is no evidence to support early return of functional activity . Traditional physiotherapy management has focussed on improving impairment ; however , there are no trials with emphasis on skill acquisition via motor re-learning principles . Material s and methods : Forty-one participants with conservatively managed distal radius fractures were studied in a r and omised , single-blinded , prospect i ve trial . Two treatment options were compared : exercise and advice versus activity-focussed physiotherapy with measurement periods of 6 weeks after removal of cast and follow-up at 24 weeks . Results : Participants allocated to the exercise and advice group consulted a physiotherapist an average of 0.9 ( SD 0.4 ) times , while the participants allocated to the more intensive activity-focussed group consulted with physiotherapy a mean of 4.4 ( SD 2.3 ) times . At both 6 and 24 weeks there were no significant differences between the groups for change in impairment ( as measured by grip strength , range of motion of wrist flexion and extension and pain intensity ) , activity limitation and participation restriction , as measured by the Patient-Rated Wrist Evaluation ( PRWE ) . Exercise and advice given by a physiotherapist were equally as effective as activity-focussed physiotherapy in recovery both at 6 and 24 weeks . Conclusion : The results suggest that after removal of cast from fracture of distal radius , patients may routinely require no more than a single session of advice and exercise provided by a physiotherapist | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,003 | 27,418,884 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . | 48,479 | 10,722,826 | Responsiveness of the short form-36, disability of the arm, shoulder, and hand questionnaire, patient-rated wrist evaluation, and physical impairment measurements in evaluating recovery after a distal radius fracture. | We evaluated the responsiveness of patient question naires and physical testing in the assessment of recovery after distal radius fracture . Patients ( n = 59 ) were assessed at their baseline clinic visit and again 3 and 6 months after injury . At each visit patients completed a short form-36 , Disability of the Arm , Shoulder , and H and question naire , and patient-rated wrist evaluation ( PRWE ) . At 3 and 6 months grip strength , range of motion , and dexterity were analyzed . St and ardized response means ( SRM ) and effects sizes were calculated to indicate responsiveness . The PRWE was the most responsive . Both the PRWE ( SRM = 2.27 ) and the Disability of the Arm , Shoulder , and H and ( SRM = 2.01 ) question naire were more responsive than the short form-36 ( SRM = 0.92 ) . The physical component summary score of the short form-36 was similar to that of the physical component subscales . Question naires were highly responsive during the 0- to 3-month time period when physical testing could not be performed . Of the physical tests , grip strength was most responsive , followed by range of motion . Responsive patient-rating scales and physical performance evaluations can assist with outcome evaluation of patients with distal radius fracture | 2,003 | Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not . | Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,480 | 26,900,504 | THE EFFECT OF AXIOSCAPULAR AND ROTATOR CUFF EXERCISE TRAINING SEQUENCE IN PATIENTS WITH SUBACROMIAL IMPINGEMENT SYNDROME: A RANDOMIZED CROSSOVER TRIAL. | BACKGROUND While physical therapy is an effective element in the rehabilitation of rotator cuff ( RC ) disease , the most effective sequence of exercise training interventions has not been defined . HYPOTHESIS/ PURPOSE The purpose of this study is to determine if there is a difference in pain or function in patients who are given RC strengthening prior to or after initiating scapular stabilization exercises . STUDY DESIGN Level I r and omized crossover trial . METHODS This was a prospect i ve study of 26 men and 14 women with a mean age 51 who were diagnosed with subacromial impingement syndrome ( SAIS ) . They were r and omly assigned to one of two groups for a comprehensive and st and ardized rehabilitation program over six visits at an orthopedic outpatient clinic . One group was prescribed a 4-week program of scapular stabilization exercises while the other group began with RC strengthening exercises . The crossover design had each group add the previously excluded four exercises to their second month of rehabilitation . RESULTS The results showed significant improvements in pain ( p < 0.001 ) , function ( p < 0.001 ) , and patient satisfaction ( p < 0.001 ) at all follow-up times for both groups . There was not a statistically significant difference in pain or function at any follow-up period for initiating one group of exercise before the other ( p > 0.05 ) . There was a statistically significant interaction between the patient 's global rating of change at the 4 week follow-up as compared to 8 weeks ( p = 0.04 ) or 16 ( p < 0.001 ) . CONCLUSION Patients with SAIS demonstrate improvement in pain and function with a st and ardized program of physical therapy regardless of group exercise sequencing . LEVEL OF EVIDENCE 1b | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,481 | 24,970,843 | A specific exercise strategy reduced the need for surgery in subacromial pain patients | Background and purpose A programme based on eccentric exercises for treating subacromial pain was in a previous study found effective at 3-month follow-up . The purpose s of the present study were to investigate whether the results were maintained after 1 year and whether the baseline Constant-Murley score , rotator cuff status and radiological findings influenced the outcome . Patients and methods 97 patients on the waiting list for arthroscopic subacromial decompression had been r and omised to a specific exercise programme or unspecific exercises ( controls ) . After 3 months of exercises , the patients were asked whether they still wanted surgery and this option was available until a 1-year follow-up . 1 year after inclusion or 1 year after surgery , the number of patients who decided to have surgery in each group was compared . The choice of surgery was related to the baseline Constant-Murley score , ultrasound and radiographs taken at inclusion . Results All patients had improved significantly ( p<0.0001 ) in the Constant-Murley score at the 1-year follow-up . Significantly more patients in the control group decided to have surgery ( 63 % ) than those in the specific exercise group ( 24 % ; p<0.0001 ) . Patients who decided to have surgery had a significantly lower baseline Constant-Murley score and more often a full-thickness tear . Patients with partial tears did not differ from those with intact tendons . Interpretation The positive short-term results of specific exercises were maintained after 1 year , and this exercise strategy reduces the need for surgery . Full-thickness tear and a low baseline Constant-Murley score appear to be a predictive marker for a less good outcome . Trial registration number Clinical trials NCT01037673 | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,482 | 10,721,508 | Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome. | STUDY DESIGN A prospect i ve r and omized clinical trial . OBJECTIVE To compare the effectiveness of 2 physical therapy treatment approaches for impingement syndrome of the shoulder . BACKGROUND Manual physical therapy combined with exercise is a commonly applied but currently unproven clinical treatment for impingement syndrome of the shoulder . METHODS AND MEASURES Thirty men and 22 women ( age 43 years + /- 9.1 ) diagnosed with shoulder impingement syndrome were r and omly assigned to 1 of 2 treatment groups . The exercise group performed supervised flexibility and strengthening exercises . The manual therapy group performed the same program and received manual physical therapy treatment . Both groups received the selected intervention 6 times over a 3-week period . The testers , who were blinded to group assignment , measured strength , pain , and function before treatment and after 6 physical therapy visits . Strength was a composite score of isometric strength tests for internal rotation , external rotation , and abduction . Pain was a composite score of visual analog scale measures during resisted break tests , active abduction , and functional activities . Function was measured with a functional assessment question naire . The visual analog scale used to measure pain with functional activities and the functional assessment question naire were also measured 2 months after the initiation of treatment . RESULTS Subjects in both groups experienced significant decreases in pain and increases in function , but there was significantly more improvement in the manual therapy group compared to the exercise group . For example , pain in the manual therapy group was reduced from a pretreatment mean ( + /- SD ) of 575.8 ( + /- 220.0 ) to a posttreatment mean of 174.4 ( + /- 183.1 ) . In contrast , pain in the exercise group was reduced from a pretreatment mean of 557.1 ( + /- 237.2 ) to a posttreatment mean of 360.6 ( + /- 272.3 ) . Strength in the manual therapy group improved significantly while strength in the exercise group did not . CONCLUSION Manual physical therapy applied by experienced physical therapists combined with supervised exercise in a brief clinical trial is better than exercise alone for increasing strength , decreasing pain , and improving function in patients with shoulder impingement syndrome | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,483 | 12,695,148 | A pragmatic randomised controlled trial of local corticosteroid injection and physiotherapy for the treatment of new episodes of unilateral shoulder pain in primary care | Objectives : To compare the long term effectiveness of local steroid injections administered by general practitioners with practice based physiotherapy for treating patients presenting in primary care with new episodes of unilateral shoulder pain . Methods : Adults consulting with shoulder pain were recruited by their general practitioner . Patients were r and omly allocated to receive either corticosteroid injections or community based physiotherapy . Primary outcome was self reported disability from shoulder problems at six months . Secondary outcomes included participant ’s global assessment of change ; pain ; function ; “ main complaint ” ; range of shoulder movement ; co- interventions . A study nurse unaware of the treatment allocation performed baseline and follow up assessment s. Analysis was by intention to treat . Results : Over 22 months 207 participants were r and omised , 103 to physiotherapy and 104 to injection . Prognostic variables were similar between the two groups at baseline . Mean ( SD ) improvements in disability scores at six weeks were 2.56 ( 5.4 ) for physiotherapy and 3.03 ( 6.3 ) for injection ( mean difference=−0.5 , 95 % confidence interval ( 95 % CI ) : −2.1 to 1.2 ) and at six months were 5.97 ( 5.4 ) for physiotherapy and 4.55 ( 5.9 ) for injection ( mean difference=1.4 , 95 % CI −0.2 to 3.0 ) . A “ successful outcome ” ( a minimum 50 % drop in the disability score from baseline ) at six months was achieved by 59/99 ( 60 % ) in the physiotherapy group and 51/97 ( 53 % ) in the injection group ( percentage difference=7 % , 95 % CI −6.8 % to 20.4 % ) . Co- interventions were more common in the injection group during follow up . Conclusion : Community physiotherapy and local steroid injections were of similar effectiveness for treating new episodes of unilateral shoulder pain in primary care , but those receiving physiotherapy had fewer co- interventions | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,484 | 26,098,920 | Efficacy of Proprioceptive Exercises in Patients with Subacromial Impingement Syndrome: A Single-Blinded Randomized Controlled Study | Objective The objective of this study was to evaluate the effectiveness of proprioceptive exercises on shoulder proprioception , range of motion , pain , muscle strength , and function in patients with subacromial impingement syndrome . Design Sixty-one patients with subacromial impingement syndrome participated in this prospect i ve , single-blind r and omized controlled trial . All patients were r and omly divided into two groups : control group ( conventional physiotherapy , n = 30 ) and intervention group ( proprioceptive exercise and conventional physiotherapy , n = 31 ) . The primary outcome measures were sense of kinesthesia and active and passive repositioning for proprioception at 0 degrees and 10 degrees external rotation at 12 wks . The secondary outcome measures were pain at rest , at night , and during activities of daily living with the visual analog scale ( 0–10 cm ) , the Western Ontario Rotator Cuff index , the American Shoulder and Elbow Surgeons index , range of motion , and isometric muscle strength at both 6 and 12 wks . Results After treatment , significant improvement was found in range of motion , pain , isometric muscle strength , kinesthesia at 0 degrees external rotation , and functional tests in both groups . The intervention group showed a significant improvement in kinesthesia at 10 degrees external rotation and active and passive repositioning at 10 degrees external rotation . When groups were compared , there were no statistically significant differences in any of the parameters at 12 wks . Conclusions Although proprioceptive exercises may provide better proprioceptive acuity , no additional positive effect on other clinical parameters was observed | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,485 | 18,752,983 | Mobilizations of the asymptomatic cervical spine can reduce signs of shoulder dysfunction in adults. | Generalized shoulder pain is a common problem that is difficult to treat and frequently recurrent . The asymptomatic cervical spine must be ruled out as a cause of any shoulder pain , as it can have a similar presentation to an isolated shoulder disorder . Previous studies have shown that lateral cervical glide mobilizations to the asymptomatic cervical spine at C5/6 can affect peripheral pain , but none have examined shoulder pain . A r and omized , blinded , placebo-controlled , cross-over trial was used to examine the immediate effects of cervical lateral glide mobilizations on pain intensity and shoulder abduction painful arc in subjects with shoulder pain . Twenty-one subjects received interventions of both cervical mobilization and placebo over two sessions . Pain intensity using a visual analog scale ( VAS ) and painful arc were assessed prior to and following application of cervical mobilization or placebo intervention . Evaluation of cervical mobilization revealed the shoulder abduction painful arc ( 12.5 degrees + /-15.6 degrees , p=0.002 ) and shoulder pain intensity ( 1.3+/-1.1 cm , p<0.001 ) were significantly decreased . The results of this study suggest that any immediate change in shoulder pain or active shoulder range of motion following cervical mobilizations indicate that treatment directed toward the asymptomatic cervical spine may expedite recovery | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,486 | 11,869,164 | Evidence for physiotherapy practice: a survey of the Physiotherapy Evidence Database (PEDro). | Evidence -based practice involves the use of evidence from systematic review s and r and omised controlled trials , but the extent of this evidence in physiotherapy has not previously been surveyed . The aim of this survey is to describe the quantity and quality of r and omised controlled trials and the quantity of systematic review s relevant to physiotherapy . The Physiotherapy Evidence Data base ( PEDro ) was search ed . The quality of trials was assessed with the PEDro scale . The search identified a total of 2,376 r and omised controlled trials and 332 systematic review s. The first trial was published in 1955 and the first review was published in 1982 . Since that time , the number of trials and review s has grown exponentially . The mean PEDro quality score has increased from 2.8 in trials published between 1955 and 1959 to 5.0 for trials published between 1995 and 1999 . There is a substantial body of evidence about the effects of physiotherapy . However , there remains scope for improvements in the quality of the conduct and reporting of clinical trials | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,487 | 4,607,209 | A randomised controlled feasibility study investigating the use of eccentric and concentric strengthening exercises in the treatment of rotator cuff tendinopathy | Objectives : To conduct a feasibility study to compare concentric and eccentric rotator cuff strengthening exercises for rotator cuff tendinopathy . Methods : A total of 11 patients with rotator cuff tendinopathy who were on the waiting list for arthroscopic subacromial decompression surgery were r and omised to perform eccentric rotator cuff strengthening exercises , concentric strengthening exercises or no exercises . Patients were evaluated in terms of levels of pain and function using the Oxford Shoulder Score and a Visual Analogue Scale initially , at 4 weeks and at 8 weeks . Results : The study design was found to be acceptable to patients and achieved a high level of 86 % compliance . The drop-out rate was 0 % . Two patients performing eccentric strengthening exercises improved sufficiently to cancel their planned surgery . Conclusion : Further research in this area is recommended . The study design was feasible and power calculations have been conducted to aid future research planning | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,488 | 2,972,614 | The effectiveness of low laser therapy in subacromial impingement syndrome: a randomized placebo controlled double‐blind prospective study | OBJECTIVES : Conflicting results were reported about the effectiveness of Low level laser therapy on musculoskeletal disorders . The aim of this study was to investigate the effectiveness of 850‐nm gallium arsenide aluminum ( Ga‐As‐Al ) laser therapy on pain , range of motion and disability in subacromial impingement syndrome . METHODS : A total of 52 patients ( 33 females and 19 males with a mean age of 53.59±11.34 years ) with subacromial impingement syndrome were included . The patients were r and omly assigned into two groups . Group I ( n = 30 , laser group ) received laser therapy ( 5 joule/cm2 at each point over maximum 5‐6 painful points for 1 minute ) . Group II ( n = 22 , placebo laser group ) received placebo laser therapy . Initially cold pack ( 10 minutes ) was applied to all of the patients . Also patients were given an exercise program including range of motion , stretching and progressive resistive exercises . The therapy program was applied 5 times a week for 14 sessions . Pain severity was assessed by using visual analogue scale . Range of motion was measured by goniometer . Disability was evaluated by using Shoulder Pain and Disability Index . RESULTS : In group I , statistically significant improvements in pain severity , range of motion except internal and external rotation and SPADI scores were observed compared to baseline scores after the therapy ( p<0.05 ) . In Group II , all parameters except range of motion of external rotation were improved ( p<0.05 ) . However , no significant differences were recorded between the groups ( p>0.05 ) . CONCLUSIONS : The Low level laser therapy seems to have no superiority over placebo laser therapy in reducing pain severity , range of motion and functional disability | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,489 | 14,573,714 | Effects of a home exercise programme on shoulder pain and functional status in construction workers | Background : Repetitive or sustained elevated shoulder postures have been identified as a significant risk factor for occupationally related shoulder musculoskeletal disorders . Construction workers exposed to routine overhead work have high rates of shoulder pain that frequently progresses to functional loss and disability . Exercise interventions have potential for slowing this progression . Aims : To evaluate a therapeutic exercise programme intended to reduce pain and improve shoulder function . Methods : Construction worker volunteers were screened by history and clinical examination to test for inclusion /exclusion criteria consistent with shoulder pain and impingement syndrome . Sixty seven male symptomatic workers ( mean age 49 ) were r and omised into a treatment intervention group ( n = 34 ) and a control group ( n = 33 ) ; asymptomatic subjects ( n = 25 ) participated as an additional control group . Subjects in the intervention group were instructed in a st and ardised eight week home exercise programme of five shoulder stretching and strengthening exercises . Subjects in the control groups received no intervention . Subjects returned after 8–12 weeks for follow up testing . Results : The intervention group showed significantly greater improvements in the Shoulder Rating Question naire ( SRQ ) score and shoulder satisfaction score than the control groups . Average post-test SRQ scores for the exercise group remained below levels for asymptomatic workers . Intervention subjects also reported significantly greater reductions in pain and disability than controls . Conclusions : Results suggest a home exercise programme can be effective in reducing symptoms and improving function in construction workers with shoulder pain | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,490 | 2,882,554 | Efficacy of standardised manual therapy and home exercise programme for chronic rotator cuff disease: randomised placebo controlled trial | Objective To investigate the efficacy of a programme of manual therapy and exercise treatment compared with placebo treatment delivered by physiotherapists for people with chronic rotator cuff disease . Design R and omised , participant and single assessor blinded , placebo controlled trial . Setting Metropolitan region of Melbourne , Victoria , Australia . Participants 120 participants with chronic ( > 3 months ) rotator cuff disease recruited through medical practitioners and from the community . Interventions The active treatment comprised a manual therapy and home exercise programme ; the placebo treatment comprised inactive ultrasound therapy and application of an inert gel . Participants in both groups received 10 sessions of individual st and ardised treatment over 10 weeks . For the following 12 weeks , the active group continued the home exercise programme and the placebo group received no treatment . Main outcome measures The primary outcomes were pain and function measured by the shoulder pain and disability index , average pain on movement measured on an 11 point numerical rating scale , and participants ’ perceived global rating of overall change . Results 112 ( 93 % ) participants completed the 22 week trial . At 11 weeks no difference was found between groups for change in shoulder pain and disability index ( 3.6 , 95 % confidence interval −2.1 to 9.4 ) or change in pain ( 0.7 , −0.1 to 1.5 ) ; both groups showed significant improvements . More participants in the active group reported a successful outcome ( defined as “ much better ” ) , although the difference was not statistically significant : 42 % ( 24/57 ) of active participants and 30 % ( 18/61 ) of placebo participants ( relative risk 1.43 , 0.87 to 2.34 ) . The active group showed a significantly greater improvement in shoulder pain and disability index than did the placebo group at 22 weeks ( between group difference 7.1 , 0.3 to 13.9 ) , although no significant difference existed between groups for change in pain ( 0.9 , −0.03 to 1.7 ) or for the percentage of participants reporting a successful treatment outcome ( relative risk 1.39 , 0.94 to 2.03 ) . Several secondary outcomes favoured the active group , including shoulder pain and disability index function score , muscle strength , interference with activity , and quality of life . Conclusion A st and ardised programme of manual therapy and home exercise did not confer additional immediate benefits for pain and function compared with a realistic placebo treatment that controlled for therapists ’ contact in middle aged to older adults with chronic rotator cuff disease . However , greater improvements were apparent at follow-up , particularly in shoulder function and strength , suggesting that benefits with active treatment take longer to manifest . Trial registration Clinical trials NCT00415441 | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,491 | 10,774,861 | Local anaesthetic injection with and without corticosteroids for subacromial impingement syndrome | Abstract Fifty patients with impingement syndrome refractory to long-term conservative treatment were r and omized to three treatment groups . All patients received an injection of 10 ml 0.5 % bupivacaine , in group 1 without corticosteroid , in group 2 with crystalline corticosteroid and in group 3 with lipoid corticosteroid . Treatment in group 1 had to be stopped because of inefficacy . In groups 2 and 3 favorable results were achieved in 19 out of 40 patients .Résumé 50 patients avec conflit sous-aeromial , qui ne montraient pas d’amélioration après un long trâitement conservatif récevaient une injection dans la bourse subacromiale . Le premier groupe récevait une injection contenant un anaesthétique local pur , groupe 2 une mixture d’anaesthétique avec des corticostéroides cristalins et groupe 3 avec des corticostéroides lipoides . Le trâitement du groupe 1 devait être arrété cause d’inificacité . 19 de 40 patients du groupe 2 et 3 montraient une amélioration après 6 mois | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,492 | 23,619,543 | Does Kinesio taping in addition to exercise therapy improve the outcomes in subacromial impingement syndrome? A randomized, double-blind, controlled clinical trial. | OBJECTIVE The aim of this study was to determine the effectiveness of Kinesio taping ( KT ) application added to the exercise treatment of subacromial impingement syndrome ( SIS ) . METHODS Thirty-eight ( 25 female , 13 male ) patients with SIS were r and omly divided into therapeutic KT ( n=19 ) and sham KT ( n=19 ) groups . All patients received the same exercise therapy in addition to therapeutic or sham KT at 3-day intervals for 12 days . The groups were compared according to pain , range of motion ( ROM ) , muscle strength and DASH and Constant scores before treatment and at the 5th and 12th treatment days . RESULTS Within group comparisons showed significant improvements in both groups at the 5th and 12th day evaluations ( p<0.05 ) . In comparisons between the groups , pain with movement and DASH scores in the therapeutic group were significantly lower at the 5th day ( p<0.01 ) . There were significant improvements in night pain , pain with movement , DASH score , shoulder external rotation muscle strength , and pain free shoulder abduction ROM in the therapeutic group at the 12th day ( p<0.05 ) . Passive shoulder flexion ROM increased more in the sham group at the 12th day ( p<0.05 ) . CONCLUSION The addition of KT application to the exercise program appears to be more effective than the exercise program alone for the treatment of SIS | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,493 | 5,803,129 | Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicentre, pragmatic, parallel group, placebo-controlled, three-group, randomised surgical trial | Summary Background Arthroscopic sub-acromial decompression ( decompressing the sub-acromial space by removing bone spurs and soft tissue arthroscopically ) is a common surgery for subacromial shoulder pain , but its effectiveness is uncertain . We did a study to assess its effectiveness and to investigate the mechanism for surgical decompression . Methods We did a multicentre , r and omised , pragmatic , parallel group , placebo-controlled , three-group trial at 32 hospitals in the UK with 51 surgeons . Participants were patients who had subacromial pain for at least 3 months with intact rotator cuff tendons , were eligible for arthroscopic surgery , and had previously completed a non-operative management programme that included exercise therapy and at least one steroid injection . Exclusion criteria included a full-thickness torn rotator cuff . We r and omly assigned participants ( 1:1:1 ) to arthroscopic subacromial decompression , investigational arthroscopy only , or no treatment ( attendance of one re assessment appointment with a specialist shoulder clinician 3 months after study entry , but no intervention ) . Arthroscopy only was a placebo as the essential surgical element ( bone and soft tissue removal ) was omitted . We did the r and omisation with a computer-generated minimisation system . In the surgical intervention groups , patients were not told which type of surgery they were receiving ( to ensure masking ) . Patients were followed up at 6 months and 1 year after r and omisation ; surgeons coordinated their waiting lists to schedule surgeries as close as possible to r and omisation . The primary outcome was the Oxford Shoulder Score ( 0 [ worst ] to 48 [ best ] ) at 6 months , analysed by intention to treat . The sample size calculation was based upon a target difference of 4·5 points ( SD 9·0 ) . This trial has been registered at Clinical Trials.gov , number NCT01623011 . Findings Between Sept 14 , 2012 , and June 16 , 2015 , we r and omly assigned 313 patients to treatment groups ( 106 to decompression surgery , 103 to arthroscopy only , and 104 to no treatment ) . 24 [ 23 % ] , 43 [ 42 % ] , and 12 [ 12 % ] of the decompression , arthroscopy only , and no treatment groups , respectively , did not receive their assigned treatment by 6 months . At 6 months , data for the Oxford Shoulder Score were available for 90 patients assigned to decompression , 94 to arthroscopy , and 90 to no treatment . Mean Oxford Shoulder Score did not differ between the two surgical groups at 6 months ( decompression mean 32·7 points [ SD 11·6 ] vs arthroscopy mean 34·2 points [ 9·2 ] ; mean difference −1·3 points ( 95 % CI −3·9 to 1·3 , p=0·3141 ) . Both surgical groups showed a small benefit over no treatment ( mean 29·4 points [ SD 11·9 ] , mean difference vs decompression 2·8 points [ 95 % CI 0·5–5·2 ] , p=0·0186 ; mean difference vs arthroscopy 4·2 [ 1·8–6·6 ] , p=0·0014 ) but these differences were not clinical ly important . There were six study -related complications that were all frozen shoulders ( in two patients in each group ) . Interpretation Surgical groups had better outcomes for shoulder pain and function compared with no treatment but this difference was not clinical ly important . Additionally , surgical decompression appeared to offer no extra benefit over arthroscopy only . The difference between the surgical groups and no treatment might be the result of , for instance , a placebo effect or postoperative physiotherapy . The findings question the value of this operation for these indications , and this should be communicated to patients during the shared treatment decision-making process . Funding Arthritis Research UK , the National Institute for Health Research Biomedical Research Centre , and the Royal College of Surgeons ( Engl and ) | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,494 | 4,893,247 | Exercise therapy after ultrasound-guided corticosteroid injections in patients with subacromial pain syndrome: a randomized controlled trial | Background Subacromial pain syndrome ( SAPS ) accounts for around 50 % of all cases of shoulder pain . The most commonly used treatments are glucocorticosteroid ( steroid ) injections and exercise therapy ; however , despite treatment SAPS patients often experience relapse of their symptoms . Therefore the clinical effect of combining steroid and exercise therapy is highly relevant to clarify . The aim of this r and omized controlled trial was to investigate if exercise therapy added to steroid injection in patients with SAPS will improve the effect of the injection therapy on shoulder pain . Methods In this two-arm r and omized trial running over 26 weeks , patients with unilateral shoulder pain ( > 4 weeks ) and thickened subacromial bursa ( > 2 mm on US ) were included . At baseline all participants received two steroid injections into the painful shoulder with an interval of one week . Subsequently they were r and omized ( 1:1 ) to either 10 weeks exercise of the involved shoulder ( intervention group ) or exercise of the uninvolved shoulder ( control group ) . The patients were re-examined after the exercise program ( at week 13 ) and again at week 26 . The primary outcome assessed after 26 weeks was change in shoulder pain analyzed using the intention-to-treat principle ( non-responder imputation ) . Results Ninety-nine SAPS patients ( 58 female ) participated ( 49 intervention/50 control ) . At both follow up visits ( week 13 and 26 ) no statistically significant between-group differences in pain changes on a visual analog scale ( mm ) were seen ( 13 weeks : pain at rest 1.7 ( 95 % CI –3.6 to 7.0 ; P = 0.53 ) ; pain in activity 2.2 ( 95 % CI –6.5 to 10.9 ; P = 0.61 ) , 26 weeks : rest 5.6 ( 95 % CI –0.9 to 12.1 ; P = 0.09 ) ; activity 2.2 ( 95 % CI –6.8 to 11.2 ; P = 0.62 ) . The reduction in pain was most evident in the control group at all four pain measurements . The only difference between groups was seen by US examination at week 13 , where fewer participants with impingement were observed in the intervention group compared with the controls ( 9 vs. 19 participants ; P = 0.03 ) . Conclusion Exercise therapy in the painful shoulder in SAPS patients did not improve the effectiveness of steroid injections for shoulder pain in patients with unilateral SAPS and enlarged subacromial bursa on US examination . Trial registration Clinical Trials.gov ( NCT01506804 ) . Registration date 5 May 2011 | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,495 | 25,211,291 | Effectiveness of physiotherapy and costs in patients with clinical signs of shoulder impingement syndrome: One-year follow-up of a randomized controlled trial. | OBJECTIVES To investigate the effect of manual physiotherapy and exercises compared with exercises alone in patients with shoulder impingement syndrome one year after inclusion . DESIGN R and omized controlled trial . SUBJECTS Patients with shoulder impingement of more than 4 weeks . METHODS The intervention group received individualized manual physiotherapy plus individualized exercises ; the control group received individualized exercises only . Both groups had 10 treatments over 5 weeks ; afterwards all patients continued their exercises for another 7 weeks at home . Primary outcomes were the Shoulder Pain and Disability Index and Patients ' Global Impression of Change . The Generic Patient-Specific Scale was used as secondary outcome . Costs were recorded in a log-book . RESULTS Ninety patients were included in the study and 87 could be analyzed at 1-year follow-up . Both groups showed significant improvements in all outcome measures , but no difference was detected between the groups . Only costs differed significantly in favour of the control group ( p = 0.03 ) after 5 weeks . CONCLUSION Individualized exercises result ed in lower costs than manual physiotherapy and showed a significant effect on pain and functioning within the whole group after one year . Exercises should therefore be considered as a basic treatment . Due to the progressive improvement that occurred during the follow-up period with individualized exercises further treatments should be delayed for 3 to 4 months | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,496 | 3,282,676 | Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study | Objective To evaluate if a specific exercise strategy , targeting the rotator cuff and scapula stabilisers , improves shoulder function and pain more than unspecific exercises in patients with subacromial impingement syndrome , thereby decreasing the need for arthroscopic subacromial decompression . Design R and omised , participant and single assessor blinded , controlled study . Setting Department of orthopaedics in a Swedish university hospital . Participants 102 patients with long st and ing ( over six months ) persistent subacromial impingement syndrome in whom earlier conservative treatment had failed , recruited through orthopaedic specialists . Interventions The specific exercise strategy consisted of strengthening eccentric exercises for the rotator cuff and concentric/eccentric exercises for the scapula stabilisers in combination with manual mobilisation . The control exercise programme consisted of unspecific movement exercises for the neck and shoulder . Patients in both groups received five to six individual guided treatment sessions during 12 weeks . In between these supervised sessions the participants performed home exercises once or twice a day for 12 weeks . Main outcome measures The primary outcome was the Constant-Murley shoulder assessment score evaluating shoulder function and pain . Secondary outcomes were patients ’ global impression of change because of treatment and decision regarding surgery . Results Most ( 97 , 95 % ) participants completed the 12 week study . There was a significantly greater improvement in the Constant-Murley score in the specific exercise group than in the control exercise group ( 24 points ( 95 % confidence interval 19 to 28.0 ) v 9 points ( 5 to 13 ) ; mean difference between group : 15 points ( 8.5 to 20.6 ) ) . Significantly more patients in the specific exercise group reported successful outcome ( defined as large improvement or recovered ) in the patients ’ global assessment of change because of treatment : 69 % ( 35/51 ) v 24 % ( 11/46 ) ; odds ratio 7.6 , 3.1 to 18.9 ; P<0.001 . A significantly lower proportion of patients in the specific exercise group subsequently chose to undergo surgery : 20 % ( 10/51 ) v 63 % ( 29/46 ) ; odds ratio 7.7 , 3.1 to 19.4 ; P<0.001 ) . Conclusion A specific exercise strategy , focusing on strengthening eccentric exercises for the rotator cuff and concentric/eccentric exercises for the scapula stabilisers , is effective in reducing pain and improving shoulder function in patients with persistent subacromial impingement syndrome . By extension , this exercise strategy reduces the need for arthroscopic subacromial decompression within the three month timeframe used in the study . Trial registration Clinical trials | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,497 | 27,220,527 | Short-term effects of high-intensity laser therapy, manual therapy, and Kinesio taping in patients with subacromial impingement syndrome | Subacromial impingement syndrome ( SAIS ) is a major contributing factor of shoulder pain ; and treatment approaches ( Kinesio ® taping [ KT ] , Exercise [ EX ] , manual therapy [ MT ] , and high-intensity laser therapy [ HILT ] ) have been developed to treat the pain . The key objective of this study was to compare the effects of KT , MT , and HILT on the pain , the range of motion ( ROM ) , and the functioning in patients with SAIS . Seventy patients with SAIS were r and omly divided into four groups based on the treatment(s ) each group received [ EX ( n = 15 ) , KT + EX ( n = 20 ) , MT + KT + EX ( n = 16 ) , and MT + KT + HILT + EX ( n = 19 ) ] . All the patients were assessed before and at the end of the treatment ( 15th day ) . The main outcome assessment s included the evaluation of severity of pain by visual analogue scale ( VAS ) and shoulder flexion , abduction , and external rotation ROM measurements by a universal goniometry . Shoulder pain and disability index ( SPADI ) was used to measure pain and disability associated with shoulder pathology . Statistically significant differences were found in the treatment results of all parameters in MT + KT + EX and HILT + MT + KT + EX groups ( p < 0.05 ) . When the means of ROM and SPADI results of three groups were compared , statistically significant differences were found between all the groups ( p < 0.05 ) . These differences were significant especially between the groups MT + KT + EX and KT + EX ( p < 0.05 ) and HILT + MT + KT + EX and KT + EX ( p < 0.05 ) . HILT and MT were found to be more effective in minimizing pain and disability and increasing ROM in patients with SAIS . Further studies with follow-up periods are required to determine the advantages of these treatments conclusively | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,498 | 24,139,986 | Pulsed electromagnetic field and exercises in patients with shoulder impingement syndrome: a randomized, double-blind, placebo-controlled clinical trial. | OBJECTIVE To evaluate the effects of pulsed electromagnetic field ( PEMF ) and exercises in reducing pain and improving function and muscle strength in patients with shoulder impingement syndrome ( SIS ) . DESIGN Double-blind , r and omized controlled trial with a 3-month posttreatment follow-up . SETTING Outpatient rehabilitation of a public hospital . PARTICIPANTS Patients ( N=56 ) between 40 and 60 years of age , with a diagnosis of SIS , were r and omly assigned to receive active PEMF ( n=26 ; mean age , 50.1y ) or placebo PEMF ( n=30 ; mean age , 50.8y ) . INTERVENTIONS After 3 weeks of active or placebo PEMF , both groups performed the same program of exercises that focused on shoulder strengthening . MAIN OUTCOME MEASURES A visual analog scale , the University of California/Los Angeles shoulder rating scale , the Constant-Murley shoulder score , and h and held dynamometry for muscle strength were used as outcome measures at baseline ( pretreatment ) , at 3 weeks ( after active or placebo PEMF ) , at 9 weeks ( postexercise ) , and at 3 months posttreatment . RESULTS Patients in the active PEMF group had a higher level of function and less pain at all follow-up time frames compared with baseline ( P<.05 ) . However , the placebo PEMF group had increased function and reduced pain only at the 9-week and 3-month follow-ups (P<.05)-that is , after performing the associated exercises . For the shoulder dynamometry , the active PEMF group had increased strength for lateral rotation at 9 weeks ( P<.05 ) , and increased strength for medial rotation at 9 weeks and 3 months ( both P<.05 ) when compared with baseline . There was no significant difference for shoulder strength in the placebo PEMF group ( P>.05 ) , as well as no significant differences ( P>.05 ) for all outcome measures . CONCLUSIONS The combination of PEMF and shoulder exercises is effective in improving function and muscle strength and decreasing pain in patients with SIS . However , these results should be carefully interpreted because of the lack of differences between groups | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
2,004 | 31,316,592 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . | 48,499 | 21,110,409 | High-dosage medical exercise therapy in patients with long-term subacromial shoulder pain: a randomized controlled trial. | BACKGROUND AND PURPOSE Exercise therapy is a commonly used conservative therapy for long-term subacromial pain . However , there is no consensus regarding what type of exercises and dosage is most effective . The aim of this study was to compare the effect of two exercise programmes : 1 ) high-dosage ( HD ) medical exercise therapy versus 2 ) low-dosage ( LD ) exercise therapy programme for subjects with long-term subacromial pain . METHODS This study used a r and omized , controlled clinical trial with an intention-to-treat analysis . Sixty-one subjects were r and omly assigned by concealment either to an HD medical exercise therapy group ( n = 31 ) or to an LD exercise therapy group ( n = 30 ) . Pain ( visual analogue scale [ VAS ] ) and function ( Shoulder Rating Question naire [ SRQ ] ) were measured at inclusion , at end of treatment and at 6 and 12 months follow-up . RESULTS There were no differences between groups at inclusion ( baseline ) regarding any variables . During the three months treatment period , five subjects ( 8 % ) dropped out , and another seven ( 11 % ) dropped out at one-year follow-up . At the end of treatment , both pain and function had improved significantly in favour of the HD therapy , between-group differences in VAS were -2.7 ( -3.9 to 0.9 ) , and for activity limitations , the between-group differences in the SRQ increased by 24.5 points ( 14.5 - 35.7 ) . The differences between groups were both statistically and clinical ly significant at 6 and 12 months follow-up . CONCLUSION In subjects with long-term subacromial pain syndrome , HD medical exercise therapy is superior to a conventional LD exercise programme . For clinicians to obtain similar positive results with HD medical exercise therapy , factors such as good communication skills , constant close personal supervision during exercise treatment and having from three to five subjects in a group setting are important | 2,004 | In many instances , no or minimal attempts to screen were undertaken or reported . | Background Subacromial shoulder pain is a common clinical presentation with much diagnostic uncertainty .
Some of this uncertainty relates to the involvement of the cervical spine as a source or contribution to subacromial shoulder pain .
Currently , there is no accepted method of screening of the cervical spine in the presence of subacromial shoulder pain , which risks patients receiving misguided and /or ineffective interventions .
Objective To evaluate approaches used to screen the cervical spine in patients with subacromial shoulder pain . |
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